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British Journal of Anaesthesia, 2002, Vol. 88, No. 1 6-9
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial III

Blood transfusion in critical illness

L. McCrossan and G. Masterson

Transfusing blood to treat anaemia in normovolaemic, critically ill patients, is common practice. It has been estimated that one-third of all patients admitted to intensive care units in the developed world receive blood transfusions.1 Most intensivists prescribe blood with the belief that it enhances oxygen transport and may, therefore, relieve covert tissue hypoxia. Increasing an anaemic, critically ill patient’s plasma haemoglobin concentration by transfusion undoubtedly increases global oxygen delivery but there is no guarantee that an increase in regional oxygen delivery will follow. It is even less certain if increased oxygen delivery after transfusion can promote increased oxygen consumption to relieve tissue hypoxia (pathological supply dependency).

Investigators have tried to establish the existence of pathological supply dependency and define optimal oxygen transport goals in both critically ill and perioperative patients.2 3 However, they manipulated oxygen transport using fluid, inotropic and vasoactive treatments rather than blood transfusion. A transfusion threshold of 10 . . . [Full Text of this Article]

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