Triggers for use, optimal dosing, and problems associated with red cell transfusions

Red blood cell (RBC) transfusion can dramatically improve tissue oxygenation in a symptomatic anemic patient and can be life saving, but this therapy is not without risk. Careful consideration of the transfusion trigger, appropriate pretransfusion screening of the donor and recipient, and selection of the optimal RBC component on an individual patient basis can help to limit the occurrence of adverse transfusion-related events. Appropriate RBC component administration technique, careful monitoring of recipients for the development of transfusion reactions, and prompt recognition and treatment of transfusion reactions are also essential in assuring safe transfusion practice. Over the past 10 years, the establishment of national commercial blood banks as well as large regional blood donor programs has resulted in a dramatic increase in transfusion therapy for veterinary patients. In both human and veterinary medicine, the emphasis is now being placed on blood component therapy. RBC products are used for treatment of symptomatic anemia, and plasma products provide clotting factors and proteins, such as albumin and antithrombin III. Addressing transfusion needs on an individual patient basis results in more efficient use of blood products and a decreased incidence of adverse reactions associated with blood transfusion.