Metrics details A restrictive approach to blood transfusions is recommended by most current guidelines [ 1 , 2 ]. Others suggest that in some patients a more liberal transfusion strategy may be beneficial [ 3 ]. However, the extensive discussions regarding the appropriate transfusion threshold have not adequately addressed the potential impact of iatrogenic hemodilution on the hemoglobin Hb level during dynamic clinical conditions that necessitate fluid administration [ 4 , 5 ]. This editorial will attempt to describe the frequent occurrence of iatrogenic hemodilution and its potential impact on decisions to transfuse blood. The effect of fluid administration on the hemoglobin concentration Fluid administration may result in a beneficial increase in microvascular flow and perfusion pressure with a global increase in oxygen delivery DO2 and cellular oxygenation in conditions of relative volume deficit e. Such iatrogenic hemodilution may cause a paradoxical decrease in DO2 due to the resulting decrease in Hb concentration, as observed in patients who have received more colloids as part of perioperative goal-directed therapy GDT [ 6 ] and in critically ill patients who did [ 7 ] or did not [ 8 ] increase their cardiac output following fluid loading.
|Published (Last):||13 May 2005|
|PDF File Size:||5.41 Mb|
|ePub File Size:||5.9 Mb|
|Price:||Free* [*Free Regsitration Required]|
Administering of Testosterone supplement therapy  In cases of dengue fever , a high hematocrit is a danger sign of an increased risk of dengue shock syndrome. For early detection of dengue hemorrhagic fever, it is suggested that hematocrit levels be kept under observations at a minimum of every 24 hours; 3—4 hours is suggested in suspected dengue shock syndrome or critical cases of dengue hemorrhagic fever.
This increase is mediated by the increased levels of erythropoietin by the kidneys in response to hypoxia. In the —80 Health Examination Survey, there was a small rise in mean hematocrit levels in female and male adolescents that reflected a rise in annual family income. Additionally, a higher education in a parent has been put into account for a rise in mean hematocrit levels of the child.
These causes and impacts have been reported: A low hematocrit level is a sign of a low red blood cell count. One way to increase the ability of oxygen transport in red blood cells is through blood transfusion, which is carried out typically when the red blood cell count is low.
Prior to the blood transfusion, hematocrit levels are measured to help ensure the transfusion is necessary and safe. The MCV is the size of the red cells and the RDW is a relative measure of the variation in size of the red cell population. Decreased hematocrit levels could indicate life-threatening diseases such as leukemia. This could potentially lead to a small drop in hematocrit levels.
Iatrogenic hemodilution: a possible cause for avoidable blood transfusions?