The Curious Clinicians When Normal Labs Aren't Necessary
Jan 17, 2024
Discover why normal hemoglobin levels aren't always necessary for transfusions. Explore the evolution of blood transfusion practices from bloodletting to modern techniques. Learn about restrictive transfusion strategies and how the body manages acute anemia. Delve into the relationship between anemia and heart health, highlighting critical care strategies. Plus, uncover the fascinating adaptations of Antarctic ice fish that can survive without blood, offering unique insights into hemoglobin's role in medicine.
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Transfusion Targets
- Doctors typically don't aim for normal hemoglobin levels when transfusing red blood cells.
- This differs from other metrics like potassium, where normal levels are the target.
Early Transfusions
- Early transfusions used substances like wine or milk, with poor results.
- The first human-to-human transfusion occurred in 1818, using a syringe and multiple donors.
Less is More
- The TRIC trial (1999) showed restrictive transfusion strategies (7-9 g/dL) had lower in-hospital mortality than liberal strategies (10-12 g/dL).
- Many subsequent trials have reinforced the benefits of transfusing less blood.