The American College of Physicians (ACP) developed an algorithm for red blood cell transfusions in a patient with transient anemia following acute blood loss.
Clinical Finding
Response
hypovolemia
replace intravascular volume with crystalloid solution
normovolemic AND symptomatic for anemia AND autologous blood available
transfuse with autologous blood
normovolemic AND symptomatic for anemia AND autologous blood not available
consider blood salvage with reinfusion; transfuse with allogeneic units as last resort
normovolemic AND asymptomatic for anemia
monitor the patient; no transfusion necessary
If the transient blood loss can be predicted in advance, then consider:
(1) collection of autologous units
(2) hemodilution
(3) blood salvage
(4) repletion of iron, folate and vitamin B12 stores
where:
• Recent recommendations would include administration of erythropoietin.
To read more or access our algorithms and calculators, please log in or register.
