Transfusion in burn patients

Q: Blood transfusion to keep hemoglobin threshold above 10 g/dL in burn patients may improve mortality.

A) True

B) False

Answer: B

Overneeded blood transfusion in burn patients may actually contribute to increased morbidity and mortality, as burn patients hemoconcentrate during the first few hours after a severe burn. Anemia may occur as bone marrow function stays depressed in these patients. Despite this, erythropoietin has no role in burn-related anemia. 

As with any general subset of patients, except for patients with coronary syndrome (ACS) who may require a threshold of 10 g/dL, burn patients should not be treated any differently in terms of blood transfusion. Rather, restrictive blood transfusion may be preferred again to prevent hemoconcentration and avoid undue Acute Lung Injury (ALI).

#burn

#hematology

References:

1. Kwan P, Gomez M, Cartotto R. Safe and successful restriction of transfusion in burn patients. J Burn Care Res 2006; 27:826.

2. Palmieri TL, Caruso DM, Foster KN, et al. Effect of blood transfusion on outcome after major burn injury: a multicenter study. Crit Care Med 2006; 34:1602.

3. Higgins S, Fowler R, Callum J, Cartotto R. Transfusion-related acute lung injury in patients with burns. J Burn Care Res 2007; 28:56.