Transfusing Young Anemic Women: A Careful Assessment is Required

Anemia is common in young women and is usually due to iron deficiency. If anemia has a slower, subacute onset, younger patients without significant medical problems can tolerate low hemoglobin levels. Often times, however, in addition to being anemic for some time, young women may have recently bled. In this situation there is less time for the body to become used to the low red cell levels and a moderate anemia may cause symptoms, such as, shortness of breath, rapid heart beating, difficulty in exerting oneself, or profound tiredness. This is means that a careful and complete clinical assessment is required before a blood transfusion is offered and that transfusions should not be given for based on low hemoglobin levels alone. Blood transfusions come with some risks. Transfusions can rarely cause allergic reactions and transmit infections 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 for transfusions can be appropriate, or they can be given on the outpatient basis or in the emergency room.

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