The Influence of Packed Red Blood Cell Transfusion on Tissue Oxygenation

  • S. Suttner
  • J. Boldt
Conference paper


In recent years, the role of packed red blood cell (RBC) transfusion has come under intense scrutiny, with an expanding body of literature indicating that the risks of such therapy may be greater than, and the benefits less than, what has been traditionally believed. However, transfusion of packed RBCs is a potentially life-saving therapy in cases of major bleeding and remains an essential and frequently performed medical intervention. The American Association of Blood Banks reports that in 2004 nearly 29 million units of blood components were transfused, including 14 million units of packed RBCs [1]. Up to 80% of these transfusions are administered to surgical and critically ill patients. With an aging population and further advances in medical treatments and procedures requiring blood transfusions, the demand for blood continues to increase. Despite the widespread use of packed RBC transfusions for a variety of reasons, the number of indications in which such transfusions are appropriate is quite limited. In an analysis of nine studies assessing the appropriateness of RBC transfusions, inappropriate rates of 18–55% were reported [2]. However, substantial variation was found in the criteria for an appropriate or an inappropriate transfusion. In an effort to reduce the perceived overtransfusion of blood and blood components, guidelines for blood transfusion have been issued by several organizations [3, 4, 5, 6] (Table 1). These guidelines recommend that packed RBCs should be administered only when the hemoglobin (Hb) concentration is low (e.g., less than 6 g/dl in a young, healthy patient), especially when the anemia is acute.


Tissue Oxygenation Transfusion Trigger Packed RBCs Arterial Oxygen Content Orthogonal Polarization Spectral 


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Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • S. Suttner
    • 1
  • J. Boldt
    • 1
  1. 1.Department of Anesthesiology and Intensive Care MedicineKlinikum der Stadt LudwigshafenLudwigshafenGermany

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