Don't you hate it when...

[urge]

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you drop an extubated, mentating, comfortable, normal vital signs, normal acid base, well peeing pt in the ICU and the first thing they do is give blood for a htc of 22%?

I would be so upset if I were the pt.

 

[drccw]

that's my favorite.. isn't all of the transfusion data that we love to rely on from the critical care literature....

 

[Idiopathic]

why are they in the ICU

 

[coprolalia]

ASA guidelines say transfusion is almost never necessary for a Hb > 10 and almost always necessary for a Hb < 6. In between is where the arguments arise.

If the patient has a transfusion reaction (or worse), it's outta your hands.

-copro

 

[urge]

Post scoliosis fusion with harrington rods. They all go to the icu, at least for one night, at my institution.

Now, the question is: should I have transfused in the or?

 

[coprolalia]

Now, the question is: should I have transfused in the or?

Based on the limited info you gave us, no.

-copro

 

[Idiopathic]

Post scoliosis fusion with harrington rods. They all go to the icu, at least for one night, at my institution.

Now, the question is: should I have transfused in the or?

i probably would have, i just assume these patients are going to continue to ooze and get transfused postop anyway

unless they are a super healthy ASA 1 i guess maybe yuo could let them fall to 20, although ive had a crit of 20 and let me tell you its no picnic

 

[urge]

Would the chance of post op blindness change your transfusion trigger?

 

[Idiopathic]

so i typically restrict fluids in all cases and if i had a patient with a crit of 22 after giving very little crystal and maybe some colloid then i would transfuse, because i know my iatrogenic hemodilution factor is pretty small but thats anecdotal

obviously these cases are at high risk for vision loss and anemia is a risk factor, id probably treat most of these patients like cardiac patients, no hypotension, maintain crit 28-30