Document Detail

Morbidity risk assessment in the surgically anemic patient.
MedLine Citation:
PMID:  8546245     Owner:  NLM     Status:  MEDLINE    
Clinicians have few data on which to base a decision to transfuse a surgical patient. We reviewed animal and human data to evaluate the effects that anemia and comorbidity have on surgical outcome. Experimental evidence consistently demonstrates increased cardiac output, decreased peripheral vascular resistance, and increased release of oxygen by red blood cells in response to anemia. Normal animals tolerate hemoglobin (Hb) levels down to approximately 5 g/dL. Below this level, cardiac ischemia and decreased ventricular function develop. In animals with experimental coronary artery stenosis, cardiac ischemia develops at Hb levels of 7-10 g/dL. Coexisting left ventricular hypertrophy, use of beta blockers, and hypoxemia also reduce animals' ability to tolerate anemia. The limited information on anemia tolerance of human surgical patients suggests that the presence of cardiac and pulmonary disease should influence transfusion decisions. A higher Hb threshold should be used in patients who have or are at risk of cardiac or pulmonary artery disease.
J L Carson
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of surgery     Volume:  170     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-02-13     Completed Date:  1996-02-13     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  32S-36S     Citation Subset:  AIM; IM    
Division of General Internal Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA.
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MeSH Terms
Anemia / complications,  physiopathology,  therapy*
Blood Transfusion*
Heart Diseases / complications
Lung Diseases / complications
Postoperative Complications / prevention & control*
Preoperative Care
Risk Assessment
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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