Anemia and red blood cell transfusion in the adult non-bleeding patient

Abstract

Anemia is a global health issue. It is associated with a wide variety of disease states in both medical and surgical patients. Increased morbidity and mortality are notable in patients with even mild anemia. Clinicians often consider red blood cell (RBC) transfusions as first-line therapy for patients with anemia to raise the hemoglobin (Hgb) level and increase oxygen delivery. RBC transfusion in the hemorrhaging patient can be lifeor limb-saving. However, RBC transfusion may result in serious adverse events, both acute and delayed, and thus, the medical decision to transfuse in the non-bleeding, anemic patient must be carefully considered. Recent literature identifies RBC transfusion practice, in a multitude of patient populations, can be readily avoided with attention placed on proper assessment of patient symptoms, optimal diagnosis of the etiology of the anemia, and appropriate treatment thereof. This review seeks to collate the current state of the science regarding RBC transfusions in the adult non-bleeding patient. Evidence-based alternatives to transfusion will also be briefly presented.