Red blood cell transfusion following burn

Giuseppe Curinga, Amit Jain, Michael Feldman, Mark Prosciak, Bradley Phillips, Stephen Milner

Research output: Contribution to journalReview articlepeer-review

Abstract

A severe burn will significantly alter haematologic parameters, and manifest as anaemia, which is commonly found in patients with greater than 10% total body surface area (TBSA) involvement. Maintaining haemoglobin and haematocrit levels with blood transfusion has been the gold standard for the treatment of anaemia for many years. While there is no consensus on when to transfuse, an increasing number of authors have expressed that less blood products should be transfused. Current transfusion protocols use a specific level of haemoglobin or haematocrit, which dictates when to transfuse packed red blood cells (PRBCs). This level is known as the trigger. There is no one 'common trigger' as values range from 6 g dl-1 to 8 g dl-1 of haemoglobin. The aim of this study was to analyse the current status of red blood cell (RBC) transfusions in the treatment of burn patients, and address new information regarding burn and blood transfusion management. Analysis of existing transfusion literature confirms that individual burn centres transfuse at a lower trigger than in previous years. The quest for a universal transfusion trigger should be abandoned. All RBC transfusions should be tailored to the patient's blood volume status, acuity of blood loss and ongoing perfusion requirements. We also focus on the prevention of unnecessary transfusion as well as techniques to minimise blood loss, optimise red cell production and determine when transfusion is appropriate.

Original languageEnglish (US)
Pages (from-to)742-752
Number of pages11
JournalBurns
Volume37
Issue number5
DOIs
StatePublished - Aug 2011

Keywords

  • Anemia in burn patients
  • Appropriate transfusion in burn population
  • Blood in burn
  • Blood loss
  • Blood management
  • Blood transfusion
  • Physiologic transfusion trigger
  • Red blood cells transfusion in burn patients
  • Unnecessary transfusion

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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