Transfusion in Non-Bleeding Medical and Surgical Patients

This chapter surveys the evidence surrounding transfusion of specific products in the non-bleeding patient and provides case vignettes to illustrate application of this evidence. The goal of red cell transfusion is to restore the oxygen carrying capacity of blood and to improve tissue oxygen delivery, both of which may be impaired by anaemia. In the setting of elective surgery, preoperative anaemia is common and is associated with longer hospital stay, higher in-hospital mortality and increased risk of acute myocardial infarction and stroke. Postoperative anaemia is more common due to blood loss, increased red cell turnover and haemodilution. Fresh frozen plasma is usually administered in the non-bleeding patient prophylactically to prevent bleeding. In non-bleeding patients, platelets are usually administered to prevent bleeding in those who are thrombocytopaenic, or to ameliorate the bleeding tendency associated with antiplatelet medications prior to an invasive procedure.