No blood transfusion unless the Hb is < 7 gm% in stable patients 

No blood transfusion unless the Hb is < 7 gm% in stable patients 

One unit of blood can save approximately three lives

New Delhi, January 16, 2018: Only 9.9 million units are collected against the estimated annual requirement of 10 to 12 million units. An average healthy person can donate blood four times a year, once every three months. One unit of donated blood can save up to three lives. Estimates by the World Health Organization indicate that blood donation by 1% of a country’s population is generally sufficient to meet its basic requirements for safe blood. Another way is to transfuse only when necessary and considering IV iron when iron deficiency is the cause.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “ A unit of blood (450 ml) can potentially save at least three lives. If the blood has not been segregated into its components, it can be stored for up to 35 days, when kept in CPDA anti-coagulant solution and refrigerated at 2 to 4 degrees Celsius. For segregated components, the storage time varies as follows: Platelet Concentrate – 5 days; Platelet Apherises – 5 days; Platelet Rich Plasma – 5 days; Packed Cells – 35 days; Fresh Frozen Plasma – 1 year; Cryo Anti Hemophilic Factor – 1 year; and Cryo Poor Plasma – 5 years.”

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “Rational blood transfusion is safe blood transfusion. Blood should be transfused only when necessary. If only one unit is required, don’t transfuse blood; if two units are required, transfuse one. If hemoglobin is more than 7 and the patient is stable do not transfuse blood”

  1. A restrictive policy of transfusion at a hemoglobin concentration of 7 to 8 g/dLshould guide transfusion decisions in most patients.
  2. If the patient is stable, transfusion may not be needed even when the hemoglobin level is 7 to 8 g/dL.
  3. For most medical and surgical hospitalized hemodynamically stable patients, including those in the intensive care unit or with septic shock, transfuse only to maintain the hemoglobin at >7 g/dL unless the patient is asymptomatic at a hemoglobin of 7 g/dL
  4. For patients with underlying cardiovascular disease, undergoing orthopedic surgery, or cardiac surgery, as well as ambulatory patients, transfuse only to maintain the hemoglobin at ≥7 to 8 g/dLrather than 10 g/dL

Exceptions include the following:

  • Symptomatic patients with hemoglobin <10 g/dLshould be transfused to improve hemodynamic instability and symptoms of myocardial ischemia.

For patients with acute coronary syndromes: Transfuse when the hemoglobin is <8 g/dL; Consider transfusion when the hemoglobin is between 8 and 10 g/dL; and maintain the hemoglobin ≥10 g/dL

Few things to observe before donating blood.

  • It is important for a person to have stable blood pressure, haemoglobin, and weight to be deemed fit for blood donation.
  • Eat something light before donating blood. Avoid consumption of alcohol or smoking the night before.
  • Drink enough water or other fluids. This will help you stay hydrated as the fluids get retrieved in 24 hours post blood donation. Do not consume aerated drinks or carbonated beverages.
  • Do not exercise or perform any strenuous physical activity after donating blood as there are high chances of suffering from dizziness.

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Autor: Dr. Jaswant Singh Puri, Doctor of Letters (Honoris Causa), Social Activist, Punjab Rattan, Member, Dewan