Jonathan M. Ross, MD
To the Editors: Dr. Welch and colleagues (1) are to be congratulated for their excellent review of strategies for elective red blood cell transfusion. It was comprehensive, clinically important, and scholarly. The accompanying clinical guideline article (2), endorsed by the American College of Physicians Clinical Efficacy Assessment Project (CEAP), although well constructed and clear in its intent to help, troubled me on two counts. First, the guidelines seem rigid when delineating the symptoms or signs requiring blood transfusion in normovolemic patients with persistent anemia. I question the validity of excluding all other indications, such as fatigue, depression, improvement of well
Ross JM. Strategies for Elective Red Blood Cell Transfusion. Ann Intern Med. ;117:441–442. doi: 10.7326/0003-4819-117-5-441
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Published: Ann Intern Med. 1992;117(5):441-442.
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