Transfusing Young Anemic Women: A Careful Assessment is Required – pro
Anemia is common in young women and is usually due to iron deficiency. If anemia has a slower, subacute onset, younger patients without medical problems can tolerate low hemoglobin levels. Often times, however, in addition to subacute or chronic iron deficiency anemia young women can have anemia of acute blood loss. In this situation there is less time for the body to become habituated to the low red cell levels and a moderately low hemoglobin may coexist with acute symptoms of anemia. Blood transfusions may be required in such situations. This is means that a careful and complete clinical assessment is required before blood transfusion is offered and that transfusions should not be given based on low hemoglobin levels alone. Blood transfusions come with some risks and several studies have shown that patients who receive transfusions, on average, stay in the hospital longer, have higher hospital bills, and are generally more ill than patients who did not receive a transfusion. Some studies have even shown a greater likelihood of death in extensively transfused patients. Since each unit infuses over at least four hours, and time is needed for observation between and after the two units often an admission was appropriate, or they can be given in the emergency room or in an outpatient setting.
References:
Scott BH, Seifert FC, Grimson R. Blood transfusion is associated with increased resource utilisation, morbidity and mortality in cardiac surgery. Ann Card Anaesth. 2008 Jan-Jun;11(1):15-19.
Rose AH, Kotzé A, Doolan D, Norfolk DR, Bellamy MC. Massive transfusion–evaluation of current clinical practice and outcome in two large teaching hospital trusts in Northern England. Vox Sang. Th. 2008 Jan-Jun;11(1):15-19.
UPTODATE: Practical aspects of red blood cell transfusion in adults: Storage, processing, modifications, and infusionAuthor:Steven Kleinman, MDSection Editor:Lynne Uhl, MDDeputy Editor:Jennifer S Tirnauer, MD 2022
Giancarlo Liumbruno at al, Guidelines for the transfusion of red blood cells
Blood Transfus. 2009 January; 7(1): 49–64.
Framework for the Development of an out of Acute Hospital Blood Transfusion Service – http://www.transfusionguidelines.org.uk/docs/pdfs/bbt-01_sp_tx-framework-v3.pdf, 2007
Read the Layperson version here.
A Compendium of Transfusion Practice Guidelines, 4th ed. American Red Cross. Available at: https://www.redcrossblood.org/content/dam/redcrossblood/hospital-page-documents/334401_compendium_v04jan2021_bookmarkedworking_rwv01.pdf (Accessed on March 17, 2021).