Blood Transfusion Indications

  • Jacklyn Engelbart
  • Luis J. GarciaEmail author


Numerous guidelines on blood transfusion indications have been published with many describing specific thresholds for transfusion within specified clinical scenarios. Most also stress that blood products should only be given when clinically necessary as hemoglobin levels do not guarantee adequate delivery of oxygen to tissue. In the setting of acute hemorrhage with hypovolemia, hematocrit does not immediately correlate with blood loss. Indications for blood transfusion may include trauma with massive blood loss (hemorrhage – surgical, traumatic, or nonsurgical), anemia, major surgical operation, cancer patients requiring therapy, massive blood loss or anemia in the setting of pregnancy and childbirth, hereditary disorders like hemophilia and thalassemia, critical illness, and severe burn victims. Chronic anemia may occur with chronic blood loss (hepatic disorders, bleeding disorders) or decreased erythropoiesis (malignancies, chemotherapy, other drugs suppressing bone marrow, renal disorders, and nutritional deficiencies); no clear-cut triggers have been defined so the decision to transfuse is considered on an individual basis including symptoms or functional impairment.


Blood transfusions Anemia Hemorrhage 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA

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