Hi,
I am curious what the up-to-date practices are regarding threshold for transfusing asymptomatic patients with a history of cardiac disease. I'm familiar with some of the older literature (pre-2008), but I've fallen off the critical care bus at this point, and I was having a hard time finding straight answers in the literature.
For those of you active in the ICU, when you have a patient who is status post non-cardiac surgery, and they are asymptomatic and overall doing well, is there a number that triggers transfusion under your care? What is the value, and does that value change based on other factors such as age (>80) or type of surgery. What literature do you base your decisions on? What about for medical ICU patients?
I know that the pendulum initially swung toward restrictive transfusion, and I'm unsure if the pendulum is swinging back. I think it's clear that patients without a cardiac history can tolerate significant anemia, but I've never been as certain with the more at-risk population. Obviously the risks of transfusion don't go away, but I wondered if the benefits go up.
I promise that this isn't a trap, or a setup for an argument, etc. I've just hit a dead end on my lit search, and I don't have a clear answer yet.
I am curious what the up-to-date practices are regarding threshold for transfusing asymptomatic patients with a history of cardiac disease. I'm familiar with some of the older literature (pre-2008), but I've fallen off the critical care bus at this point, and I was having a hard time finding straight answers in the literature.
For those of you active in the ICU, when you have a patient who is status post non-cardiac surgery, and they are asymptomatic and overall doing well, is there a number that triggers transfusion under your care? What is the value, and does that value change based on other factors such as age (>80) or type of surgery. What literature do you base your decisions on? What about for medical ICU patients?
I know that the pendulum initially swung toward restrictive transfusion, and I'm unsure if the pendulum is swinging back. I think it's clear that patients without a cardiac history can tolerate significant anemia, but I've never been as certain with the more at-risk population. Obviously the risks of transfusion don't go away, but I wondered if the benefits go up.
I promise that this isn't a trap, or a setup for an argument, etc. I've just hit a dead end on my lit search, and I don't have a clear answer yet.