Author: Heyes, Jennifer

BLOOD TRANSFUSION NEWSLETTER Issue 1, June 2015

Single Unit Blood Transfusions…. For non-bleeding patients
Does your non-bleeding patient really need two units or red cells? Evidence shows that restrictive blood transfusion practice does not effect patient outcomes. Using a Hb trigger of 70g/L for transfusion is nationally recommended for normovolemic patients. Only use a trigger of 80g/L if the patient has cardiovascular disease or showing symptoms of anaemia. In the majority of cases, transfusion to a Hb above 100g/L is not indicated.
Do you need to transfuse your patient if they do not have symptoms of anaemia?

Single Unit Transfusion Policy at Kings
This has been implemented in AMU and over the last 6 months there has been a reduction in red cell transfusions of ~45% for non-bleeding patients.
The policy states that only one unit of red cells should be prescribed at a time and a clinical review and Hb should be checked.
This practice is endorsed by NHS England through the Patient Blood Management Recommendations.

Did you know?
One red cell unit ≈ 270ml
Transfusing one unit of red cells will typically give a Hb rise of 10g/L in a 70-80kg non-bleeding patient.
For paediatrics and low body weight adults, dose should be calculated as 4ml/kg to get a 10g/L rise in Hb.

Symptoms of Anaemia
Fatigue
Shortness of breath at rest
Chest pain or heart palpitations
Faintness or blackouts
These symptoms must be present and attributed to low Hb and not to any underlying cause before transfusion

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