| Problem: The number of blood transfusions each year continues to rise. However, there continues to be debate regarding the appropriate laboratory value or combination of physical exam findings that should prompt a blood transfusion. Thus, there is a great deal of literature regarding blood transfusion strategies in anemic patients. The majority of the literature deals with critically ill patients, trauma patients, or patients undergoing orthopedic surgery. It has yet to be determined the minimum tolerated hemoglobin that will determine the need for blood transfusion. Specifically, there has been limited research studying anemic, post-operative patients who have undergone elective procedures. Methods: A search of PubMed and Medline was used to search for articles covering blood transfusions in post operative, anemic patients. The search was performed by using key words and phrases such as "transfusion," "trigger for transfusion," "hypovolemia and transfusion," "postoperative anemia," "postoperative transfusion," and "postoperative hemoglobin." Results: Search results provided 19 articles, 13 of which were primary research, 6 of which were review articles. Results demonstrate that there is an abundance of literature regarding transfusion practices and guidelines, though there is also a great deal of discrepancy. It is unclear whether each clinician will make the decision to transfuse based solely on individual laboratory values such as hemoglobin, or whether clinicians will take into account patient characteristics, co-morbidities, and vital signs. Conclusion: The current literature regarding the level of hemoglobin required to ensure oxygenation of perfused tissues is abundant, but it leaves many questions unanswered. |
