Breaking a myth in postransfusion control of hemoglobin/hematocrit

Abstract

Measurement of hemoglobin/hematocrit is usually carried out 6 hours after transfusion, as a parameter allowing the assessment of therapeutic result. However, there is no clear evidence to support this practice.

Objective: to determine the concordance of the levels of hemoglobin/hematocrit 15 minutes after termination of transfusion, with regard to those measured 6 hours after the procedure, in patients with chronic anemia and without active bleeding, hemolysis, or hypersplenism.

Materials and methods: an observational, analytic, concordance study was carried out in order to analyze the concordance between 2 measurements of hemoglobin/hematocrit: 15 minutes after transfusion and 6 hours after transfusion. This was done in 41 diagnosed with anemia of medical origin, without active bleeding.

Results: a highly significant concordance was found between hemoglobin at 15 minutes and 6 hours after transfusion (p<0.0001), with an intraclass correlation coefficient of 0.8793 (IC 95: 0.7817, 0.9349); highly significant concordance was also found between hematocrit at 15 minutes and 6 hours after transfusion (p<0.0001), with an intraclass correlation coefficient of 0.8456 (IC 95%: 0.7301, 0.9144).

Conclusions and discussion: although it is common practice to determine hemoglobin/hematocrit 6 hours after transfusion (without supporting evidence reported in the literature), this study found a high, significant correlation between measurements carried out at 15 minutes and 6 hours after transfusion in patients with anemia of medical origin. Immediate measurement saves time in clinical decisions