November 1, 2018 – Why Blood Can Harm

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Anchor lead: Why are too many transfusions harmful? Elizabeth Tracey reports

More and more evidence is mounting that restricting blood transfusions results in fewer problems for patients and is also less expensive, with the latest study in the New England Journal of Medicine looking at outcomes at six months after cardiac surgery. Steve Frank, a transfusion expert at Johns Hopkins, describes the consequences of transfusion.

Frank: So basically the heart and the lungs take a hit when you give patients more blood than is needed. So all these nine randomized trials, I call them landmark studies, support a restricted transfusion strategy. In other words giving patients less blood than we’re used to, say 10 years ago.  :18

Frank says now a lower hemoglobin level in the blood is used to decide when to transfuse.

Frank: The way we dose blood, if you will, is based on the hemoglobin level. We used to use a hemoglobin threshold of 10. Now these 9 randomized trials show that we should be using 7 or 8.  :12

At Johns Hopkins, I’m Elizabeth Tracey.