What Are Typical Blood Transfusion Criteria?

Jeremy Laukkonen

Specific blood transfusion criteria can vary between different jurisdictions, and even from one medical facility to another. These criteria are typically used to determine when someone should be given a transfusion and to help choose the proper blood type or specific blood components for the procedure. Some common blood transfusion criteria include a low hemoglobin count, certain cases of anemia, and acute blood loss. Transfusions can also be scheduled as a part of therapeutic treatments, so that is typically an acceptable criteria as well. Other criteria are used to determine whether a patient should receive whole blood or components such as red blood cells, platelets, or plasma.

Red blood cells are usually included in a transfusion.
Red blood cells are usually included in a transfusion.

Hospitals and other medical facilities typically maintain written lists of acceptable blood transfusion criteria to help determine when certain procedures are acceptable, and what blood or components to administer. These lists are typically not meant as a replacement for sound medical judgment, or to automatically determine whether or not a specific case requires a transfusion. A number of indications are typically given, along with specific circumstances that do not justify transfusions, and then that information can be used as a basis for making clinical judgments about each specific case.

The Rhesus Factor set of blood types.
The Rhesus Factor set of blood types.

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One of the primary blood transfusion criteria is related to hemoglobin levels. Hemoglobin is a red blood cell component that is capable of transporting oxygen, and there are a number of circumstances that can lead to reduced levels. When the amount of hemoglobin drops below a certain level per unit of blood, a transfusion may be authorized. There are typically other standards that are used if conditions such as pulmonary or coronary artery disease are present, or there is any risk of ischemia.

Two types of blood on a blood typing test card.
Two types of blood on a blood typing test card.

Another criteria for blood transfusion is acute blood loss, which is the sudden loss of a large volume of blood. A loss of about 15% or more of the total blood volume is typically sufficient to meet this type of criteria. Blood pressure may also be used to determine whether this criteria is met, and there are generally specific systolic and diastolic levels that can indicate the need for a transfusion. Anemia is another condition that can require transfusions, especially if symptoms such as tachycardia or cardiac ischemia are experienced.

A blood donation station.
A blood donation station.

In addition to all of the different situations that can require the procedure, there are also common blood transfusion criteria that can help determine when to administer whole blood or various different blood components. When it is necessary to both increase blood volume and increase the ability of the blood to carry oxygen, red blood cells with a colloid replacement are sometimes indicated. Platelets are typically administered if the platelet count is below a specific level, or if a patient has a history of platelet dysfunction. Many other blood components and specialized treatments also have their own criteria for administration.

One empty and one full pint-sized blood bag.
One empty and one full pint-sized blood bag.
Blood pressure might be used to determine if blood transfusion criteria have been met.
Blood pressure might be used to determine if blood transfusion criteria have been met.
A bag of blood plasma.
A bag of blood plasma.

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