Blood Transfusion: Administration

A transfusion is not simply “giving blood.” The prescribed component must match the physiological problem: - Red cells increase oxygen-carrying capacity. - Platelets support primary haemostasis. - Plasma supplies multiple clotting factors. - Cryoprecipitate provides concentrated fibrinogen and selected factor proteins. Patient blood management therefore asks three questions before a unit is ordered: Is transfusion indicated? Has the underlying cause been treated where possible? Can blood loss be reduced or replaced with another therapy? For example, iron deficiency anaemia should be investigated and treated rather than repeatedly corrected with red cells when time allows. For a haemodynamically stable hospitalized adult who is not actively bleeding, a red-cell threshold near 70 g/L is commonly used. A threshold near 75 g/L may be used in cardiac surgery and near 80 g/L in orthopedic surgery or pre-existing cardiovascular disease. These values prompt clinical assessment; they do not automatically mandate transfusion. Symptoms, active bleeding, tissue hypoxia, comorbidities, and the trajectory of haemoglobin still determine the decision. A non-bleeding patient usually receives one red-cell unit followed by reassessment of symptoms and haemoglobin before another unit...