Indications and types of transfusion in the management of ACS
| Simple transfusion . | Exchange transfusion . |
|---|---|
| • SpO2 < 95% on room air • Hb <5 g/dL • PCV/Hb level 10%-20% below the patient's steady-state PCV/Hb • Dropping Hb/PCV during hospitalization • Clinical or radiological progression of disease without impending respiratory failure • As a temporizing measure while awaiting/preparing for EBT | • Severe hypoxemia (SpO2 ≤ 85%) • High pretransfusion Hb levels (≥8-10 g/dL) that preclude simple transfusion • Previous history of severe ACS or cardiopulmonary disease • Multilobar disease (>1 lobe affected) on chest radiograph • Rapidly progressive ACS or multiorgan failure syndrome despite simple transfusion • Declining SpO2 readings despite increasing oxygen delivery, particularly if the declining SpO2 occurs over a brief period of several hours |
| Simple transfusion . | Exchange transfusion . |
|---|---|
| • SpO2 < 95% on room air • Hb <5 g/dL • PCV/Hb level 10%-20% below the patient's steady-state PCV/Hb • Dropping Hb/PCV during hospitalization • Clinical or radiological progression of disease without impending respiratory failure • As a temporizing measure while awaiting/preparing for EBT | • Severe hypoxemia (SpO2 ≤ 85%) • High pretransfusion Hb levels (≥8-10 g/dL) that preclude simple transfusion • Previous history of severe ACS or cardiopulmonary disease • Multilobar disease (>1 lobe affected) on chest radiograph • Rapidly progressive ACS or multiorgan failure syndrome despite simple transfusion • Declining SpO2 readings despite increasing oxygen delivery, particularly if the declining SpO2 occurs over a brief period of several hours |
PCV, packed cell volume.
Adapted with permission from Field and Willen.40 Copyright © 2022 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.