What are the indications for blood transfusion?

Mar 04, 2024 Source: Cainiu Health

Dr. Liu Feng

Introduction

Generally, indications for blood transfusion include hemorrhagic shock, severe anemia, major surgical bleeding, coagulation disorders, and severe infections. If any adverse reactions occur, immediate medical attention is recommended. For each case, careful assessment of the patient's condition and the risks associated with transfusion should be conducted prior to transfusion to ensure its safety and effectiveness.

Generally, indications for blood transfusion include hemorrhagic shock, severe anemia, massive bleeding during surgery, coagulation disorders, and severe infections. If any discomfort occurs, it is recommended to seek immediate medical treatment. The details are as follows:

1. Hemorrhagic Shock: Hemorrhagic shock is an acute circulatory failure state caused by severe blood loss leading to a rapid reduction in circulating blood volume, resulting in a sharp drop in blood pressure and inadequate organ and tissue perfusion, which can be life-threatening. In cases of hemorrhagic shock, prompt transfusion of packed red blood cells or whole blood rapidly restores lost blood volume, maintains effective circulating volume, ensures oxygen supply-demand balance in organs and tissues, and thus prevents multi-organ failure and death.

2. Severe Anemia: Severe anemia refers to a pathological condition in which the number of red blood cells or hemoglobin concentration in the blood is significantly below the normal range, leading to insufficient oxygen delivery to tissues and organs. For patients with severe anemia—especially those exhibiting obvious symptoms—blood transfusion can quickly increase red blood cell count and hemoglobin levels, improve oxygen supply-demand balance in tissues and organs, relieve related symptoms, and enhance quality of life.

3. Massive Surgical Bleeding: During certain surgical procedures, severe bleeding may occur, endangering patient safety. In such cases, rapid transfusion of blood and blood products can effectively control bleeding, maintain blood volume and circulatory stability, and ensure the successful completion of surgery.

4. Coagulation Disorders: Coagulation disorders may result from inherited combined clotting factor deficiencies, hemophilia, anticoagulant medication use, or other diseases causing disruption of the clotting mechanism. In these cases, transfusion of fresh frozen plasma or clotting factor concentrates effectively replenishes missing clotting factors, corrects coagulation dysfunction, and prevents or controls bleeding.

5. Severe Infection: In cases of severe infection, factors such as inflammatory response, microcirculatory disturbance, and bleeding tendency may lead to significant blood loss and coagulation disorders. Blood transfusion can rapidly restore blood volume, improve oxygen supply-demand balance in tissues and organs, and help correct coagulation dysfunction through transfusion of fresh frozen plasma or clotting factor concentrates, thereby assisting the patient through the critical phase.

For each of these conditions, careful assessment of the patient's clinical status and transfusion risks is required before proceeding, to ensure the safety and effectiveness of blood transfusion.

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What should be done if a fever reaction occurs during blood transfusion?

A fever reaction during blood transfusion requires immediate cessation of the transfusion, monitoring of vital signs, administration of antipyretic medications as prescribed, identification of the underlying cause, and adjustment of subsequent transfusion plans. If fever is accompanied by chills, difficulty breathing, or a drop in blood pressure, medical staff must be notified immediately for emergency management. Should fever (body temperature ≥38°C) occur during transfusion, healthcare providers should be informed without delay.