ANEMIA

DEFINITION
Anemia is defined as a decrease in red blood cell (RBC) mass.
RBC deliver oxygen from the lungs to the tissues and carbon dioxide from
the tissues to the lungs hemoglobin (Hb)
Measuring RBC mass are time consuming and expensive Hb concentration
and hematocrit (Ht).

CLASSIFICATION
By morphology
Microcytic Hypochromic
Normocytic Normochromic
Macrocytic
Mean corpuscular volume (MCV)= Hct x 10/RBC (84-96 fL)
Mean corpuscular Hb (MCH) = Hb x 10/RBC (26-36 pg)
Mean corpuscular Hb concentration (MCHC) = Hb x 10/Hct (32-36%)

CLINICAL MANIFESTATION
Pallor
Pale conjunctivae
Palpitation
Lethargy
Signs of cardiac failure
Weakness
Shortness of breath
Headache
Blurry vision
Nausea

TREATMENT
RBC Transfusion
Proper uses of red blood cell (RBC) transfusion:
Treatment of symptomatic anemia
Prophylaxis in life-threatening anemia
Restoration of oxygen-carrying capacity in case of hemorrhage

RBC transfusion is not routinely indicated for pharmacologically treatable

anemia such as:

Iron deficiency anemia

Vitamin B or folate deficiency anemia

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 Dosage and administration

One unit of RBC will raise the hemoglobin of an average-size adult

by ~1g/dL (or raise HCT ~3%)

ABO group of RBC products must be compatible with ABO
group of recipient
RBC product must be serologically compatible with the
recipient
Rate of transfusion
Transfuse slowly for first 15 minutes

Complete transfusion within 4 hours

 Different guidelines recommended transfusion not indicated for Hb

>10g/dL,but the lower threshold varies from 6g/dLto 8g/dL
Hb <6g/dL Transfusion recommended except in exceptional circumstances
Hb 6 to 7g/dL Transfusion generally likely to be indicated
Hb 7 to 8g/dL Transfusion should be considered in postoperative surgical patients,
including those with stable cardiovascular disease, after evaluating the patients
clinical status
Hb 8 to 10g/dL Transfusion generally not indicated, but should be considered for
some populations (eg, those with symptomatic anemia, ongoing bleeding, acute
coronary syndrome with ischemia)
Hb >10g/dL Transfusion generally not indicated except in exceptional circumstances