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Equilibration of Hemoglobin Concentration after Transfusion in Medical Inpatients Not Actively Bleeding

Andrew R. Wiesen, MD; Duane R. Hospenthal, MD, PhD; John C. Byrd, MD; Kevin L. Glass, MD; Robin S. Howard, MA; and Louis F. Diehl, MD
[+] Article and Author Information

From the Walter Reed Army Medical Center, Washington, D.C. Requests for Reprints: Andrew R. Wiesen, MD, Internal Medicine Clinic, Lister Army Community Hospital, Ft. Rucker, AL 36362.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1994;121(4):278-280. doi:10.7326/0003-4819-121-4-199408150-00009
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More than 12 million units of packed erythrocytes are transfused annually [12]. Because blood products became widely used after World War II, hundreds of millions of units have been given [14]. Major textbooks state that an increase of 10 g/L (1 g/dL) of hemoglobin is expected per unit of blood transfused [510]. Authors [5, 8, 11] have implied that after transfusion, the rate at which the hemoglobin concentration equilibrates takes about 24 hours, but the supporting evidence is scant. The ability to rapidly determine the increase in hemoglobin levels after transfusion is important in managing outpatients and acutely ill patients. A standard time to measure the hemoglobin levels would save unnecessary blood draws.

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Figure 1.
Increase in hemoglobin concentration after transfusion.P

The increase in hemoglobin concentration after a 2-unit transfusion of packed erythrocytes was 20 ±2 g/L ( < 0.001). Values are expressed as mean ±SE; error bars represent the SE.

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Grahic Jump Location
Figure 2.
Change in hemoglobin concentration over time.

Differences in hemoglobin concentrations between 24 hours after transfusion and 15 minutes, 1 hour, and 2 hours after a 2-unit transfusion of packed erythrocytes.

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