Blood Transfusion Therapy in Patients with Heart Disease.
BOSTON UNIV MA SCHOOL OF MEDICINE
Pagination or Media Count:
The oxygen transport function of preserved red cells transfused to anemic patients who have heart disease is critical. Patients with heart disease should be given red cells with normal 2,3 DPG and normal affinity for oxygen instead of low 2,3 DPG red cells. Our studies suggest that red cells with high 2,3 DPG 150 to 200 of normal and low affinity for oxygen are the best form of transfusion therapy for anemic patients, especially those with congestive heart failure. It may even prove useful to use 2,3 DPG-enriched red cells in patients with patchy myocardial ischemia and, at any rate, it can do not harm. High 2,3 DPG red blood cells also are recommended in patients with right-to-left cardiac shunts and pulmonary shunts, provided that the inspired ambient oxygen tension is adequate to maintain an arterial pO2 tension of greater than 40 mm Hg. Blood products utilized during extracorporeal bypass surgery should ensure optimum oxygen delivery to tissue and maintain or restore normal hemostasis, and red cells with 250 to 300 of normal, 2,3 DPG and low afinity for oxygen given in combination with crystalloid solution will do this. Red cells with elevated 2,3 DPG levels do ensure optimum delivery of oxygen to tissue, especially during hypothermia, although it cannot be stated definitely whether ornot they reduce myocardial damage.
- Medicine and Medical Research