Title

Is there an optimal hemoglobin value in the cardiac intensive care unit?

Publication/Presentation Date

10-1-2003

Abstract

Anemia is common in patients admitted to the cardiac intensive care unit. Many unique issues must be considered in the treatment of the anemic cardiac patient. Coronary artery disease and left ventricular dysfunction may significantly increase the risk of anemia. These patients have limited reserve because of a high extraction ratio of oxygen in the cardiac circulation. Left ventricular dysfunction increases the risk of complications from transfusion. Recent observational studies suggest that cardiac patients may benefit from a higher transfusion threshold. However, very few patients with cardiovascular disease have been included in clinical trials comparing high and low transfusion triggers. Experimental data and recent studies in humans suggest that cardiac patients may be intolerant of anemia. Pending definitive clinical trials in cardiac patients, we suggest a more aggressive transfusion trigger (9-10 g/dL) in patients with active cardiac disease. Pulmonary edema may be precipitated by transfusion in patients with left ventricular dysfunction. Large clinical trials are urgently needed to determine optimal transfusion thresholds in patients with cardiovascular disease.

Volume

9

Issue

5

First Page

356

Last Page

361

ISSN

1070-5295

Disciplines

Cardiology | Medical Sciences | Medical Specialties | Medicine and Health Sciences

PubMedID

14508147

Department(s)

Department of Medicine, Cardiology Division, Department of Medicine Faculty

Document Type

Article