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Related Experiment Videos

A physiologic basis for red blood cell transfusion decisions

A G Greenburg1

  • 1Department of Surgery, Miriam Hospital, Providence, Rhode Island 02906, USA.

American Journal of Surgery
|December 1, 1995
PubMed
Summary

Surgeons seek a universal red blood cell transfusion trigger. This study explores global oxygen delivery physiology, suggesting transfusion is needed when oxygen delivery critically drops, impacting tissue perfusion.

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Area of Science:

  • Physiology
  • Transfusion Medicine
  • Critical Care Medicine

Background:

  • A universal "transfusion trigger" for red blood cell (RBC) transfusion remains elusive in surgical practice.
  • Optimizing cardiopulmonary hemodynamics is crucial before deciding on RBC transfusion.
  • Current monitoring of global oxygen delivery relies on invasive techniques.

Purpose of the Study:

  • To explore aspects of global oxygen delivery physiology.
  • To identify physiological parameters correlating with cardiac function, metabolism, and tissue perfusion.
  • To inform the development of a "transfusion trigger".

Main Methods:

  • Review of global oxygen delivery physiology.
  • Analysis of parameters indicating critical oxygen delivery.

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  • Discussion of invasive monitoring techniques.

    • Main Results:

    • Global oxygen delivery falling below a critical threshold necessitates RBC transfusion.
    • Increasing oxygen extraction and lactate levels indicate critical oxygen delivery.
    • Physiological parameters correlate with cardiac function, metabolism, and tissue perfusion.

    Conclusions:

    • Understanding global oxygen delivery physiology is key to determining transfusion needs.
    • Invasive monitoring currently dictates transfusion decisions.
    • Further research into non-invasive monitoring could aid in identifying a "transfusion trigger".