The American College of Physicians (ACP) developed an algorithm for red blood cell transfusions in a patient with persistent anemias.
|
Clinical Finding |
Response |
|
hypovolemia |
replace intravascular volume with crystalloid solution; identify and treat causes of hypovolemia |
|
normovolemic AND deficient in iron, folate and/or vitamin B12 |
replace whatever is deficient |
|
normovolemic AND renal insufficiency |
treat with erythropoietin with iron as needed |
|
normovolemic AND being treated with zidovudine AND serum erythropoietin level low |
treat with erythropoietin with iron as needed |
|
normovolemic AND symptomatic for anemia |
transfuse allogeneic red blood cells |
|
normovolemic AND asymptomatic for anemia |
monitor the patient; no transfusion necessary |
where:
• Persistent hypovolemia probably will not be solved by a crystalloid infusion. The cause needs to be identified and treated.
• If the patient has source of blood loss, then these should be treated.
Specialty: Clinical Laboratory
