ABSTRACT
Having detected the presence of anaemia and its causation, it is necessary to decide whether the anaemia should be corrected and by what means. There is a tendency to transfuse blood less frequently ia than previously because of possible complications, which are outlined in Chapter 14. The rationale of the traditionally accepted minimum Hb concentration of 10 g/dl for elective surgery is based on the benefits of reduced viscosity, which reduces myocardial work and yet oxygen flux is maintained (see Chapter 14). However, below this Hb concentration, myocardial work has to increase substantially to maintain oxygen flux. The decision to transfuse blood to correct anaemia needs to take into account the following:
• Is the circulating volume reduced? If bleeding is acute and continuing, surgery should take place to stop the bleeding at the same time as giving blood.
