Use of red cells
Use red cells for treatment of clinically significant anaemia with symptomatic deficit of oxygen carrying capacity.
You can also use red cells for replacement of traumatic or surgical blood loss. A paediatric dose should be used in infants and young children, and for intrauterine transfusion.
Washed, leucocyte depleted red cells is indicated for patients who have IgA deficiency with antibodies against IgA. It may reduce the incidence of severe recurrent febrile, urticarial and possible anaphylactic transfusion reactions in multitransfused patients.
Although important, the patient’s haemoglobin level should not be the sole deciding factor for giving red cells.
Depending upon the condition of the patient, transfusion of red cells may not be necessary even with low haemoglobin concentration.
| Considerations for Corresponding Haemoglobin Levels (1) | |
| Haemoglobin | Considerations |
| <70 g/L | Lower thresholds may be acceptable in patients without symptoms and/or where specific therapy is available. |
| 70–100 g/L | Likely to be appropriate during surgery associated with major blood loss or if there are signs or symptoms of impaired oxygen transport. |
| >80 g/L | May be appropriate to control anaemia-related symptoms in a patient on a chronic transfusion regimen or during marrow suppressive therapy. |
| >100 g/L | Not likely to be appropriate unless there are specific indications. |
If you want to know about the appropriate use of red cells, know the specific factors to consider when using red cells to help you in your decision.
Contraindications
Do not use red cells if anaemia can be treated with specific medications such as iron, vitamin B12, folic acid or recombinant erythropoietin and the clinical condition of the patient permits sufficient time for these agents to promote erythropoiesis.
Dosage
Each unit of red cells raises the haemoglobin concentration in an average sized adult by approximately 10 g/L.
Use blood of identical ABO group and Rh(D) type as the recipient whenever possible.
However, group O red cells can be used in an emergency when the recipient’s blood group is unknown. In this situation, a blood sample should be taken for blood grouping prior to commencing transfusion.
Reference
- National Health and Medical Research Council & Australasian Society of Blood Transfusion. Clinical Practice Guidelines on the Use of Blood Components. Commonwealth of Australia, October 2002.
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