Editing Blood transfusion (section)

=== Red cell transfusion ===
{{Main|Packed red blood cells}}
[[File:Blood transfusion B.jpg|thumb|The patient receives a blood transfusion through the cannula.]]
[[File:Blood bag 2020.jpg|thumb|Banked blood during the blood transfusion process]]
[[File:Blood unit during transfusion.jpg|alt=Blood bag during a blood transfusion procedure|thumb|As the person receives their blood transfusion, the bag slowly empties, leaving behind blood that has clotted before it could be administered.]]
Historically, [[Packed red blood cells|red blood cell transfusion]] was considered when the [[hemoglobin]] level fell below 100g/L or [[hematocrit]] fell below 30%.<ref>{{cite journal |vauthors=Adams RC, Lundy JS | year = 1942 | title = Anesthesia in cases of poor surgical risk. Some suggestions for decreasing risk | journal = Surg Gynecol Obstet | volume = 74 | pages = 1011–9 }}</ref><ref name="AABB2012">{{cite journal | vauthors = Carson JL, Grossman BJ, Kleinman S, Tinmouth AT, Marques MB, Fung MK, Holcomb JB, Illoh O, Kaplan LJ, Katz LM, Rao SV, Roback JD, Shander A, Tobian AA, Weinstein R, Swinton McLaughlin LG, Djulbegovic B | display-authors = 6 | title = Red blood cell transfusion: a clinical practice guideline from the AABB* | journal = Annals of Internal Medicine | volume = 157 | issue = 1 | pages = 49–58 | date = July 2012 | pmid = 22751760 | doi = 10.7326/0003-4819-157-1-201206190-00429 | doi-access = free | others = Clinical Transfusion Medicine Committee of the, AABB }}</ref> Because each unit of blood given carries risks, a trigger level lower than that, at 70 to 80g/L, is now usually used, as it has been shown to have better patient outcomes.<ref name="AABBfive">{{Citation |date= 24 April 2014 |title= Five Things Physicians and Patients Should Question |publisher= American Association of Blood Banks |work= [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |url= http://www.choosingwisely.org/doctor-patient-lists/american-association-of-blood-banks |access-date= 25 July 2014 |archive-date= 24 September 2014 |archive-url= https://web.archive.org/web/20140924075027/http://www.choosingwisely.org/doctor-patient-lists/american-association-of-blood-banks/ |url-status= live }}</ref><ref>{{cite journal | vauthors = Carson JL, Stanworth SJ, Dennis JA, Trivella M, Roubinian N, Fergusson DA, Triulzi D, Dorée C, Hébert PC | display-authors = 6 | title = Transfusion thresholds for guiding red blood cell transfusion | journal = The Cochrane Database of Systematic Reviews | volume = 12 | issue = 12 | pages = CD002042 | date = December 2021 | pmid = 34932836 | pmc = 8691808 | doi = 10.1002/14651858.CD002042.pub5 }}</ref><ref name="Carson JL 1902">{{cite journal | last1=Carson | first1=Jeffrey L. | last2=Stanworth | first2=Simon J. | last3=Guyatt | first3=Gordon | last4=Valentine | first4=Stacey | last5=Dennis | first5=Jane | last6=Bakhtary | first6=Sara | last7=Cohn | first7=Claudia S. | last8=Dubon | first8=Allan | last9=Grossman | first9=Brenda J. | last10=Gupta | first10=Gaurav K. | last11=Hess | first11=Aaron S. | last12=Jacobson | first12=Jessica L. | last13=Kaplan | first13=Lewis J. | last14=Lin | first14=Yulia | last15=Metcalf | first15=Ryan A. | last16=Murphy | first16=Colin H. | last17=Pavenski | first17=Katerina | last18=Prochaska | first18=Micah T. | last19=Raval | first19=Jay S. | last20=Salazar | first20=Eric | last21=Saifee | first21=Nabiha H. | last22=Tobian | first22=Aaron A. R. | last23=So-Osman | first23=Cynthia | last24=Waters | first24=Jonathan | last25=Wood | first25=Erica M. | last26=Zantek | first26=Nicole D. | last27=Pagano | first27=Monica B. | title=Red Blood Cell Transfusion: 2023 AABB International Guidelines | journal=JAMA | volume=330 | issue=19 | date=2023-11-21 | issn=1538-3598 | pmid=37824153 | doi=10.1001/jama.2023.12914 | pages=1892–1902}}</ref> The administration of a single unit of blood is the standard for hospitalized people who are not bleeding, with this treatment followed with re-assessment and consideration of symptoms and hemoglobin concentration.<ref name="AABBfive" /> Patients with poor [[Oxygen saturation (medicine)|oxygen saturation]] may need more blood.<ref name="AABBfive" /> The advisory caution to use blood transfusion only with more severe [[anemia]] is in part due to evidence that outcomes are worsened if larger amounts are given.<ref>{{cite journal | vauthors = Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C | display-authors = 6 | title = Transfusion strategies for acute upper gastrointestinal bleeding | journal = The New England Journal of Medicine | volume = 368 | issue = 1 | pages = 11–21 | date = January 2013 | pmid = 23281973 | doi = 10.1056/NEJMoa1211801 | doi-access = free }}</ref> One may consider transfusion for people with symptoms of [[cardiovascular disease]] such as chest pain or shortness of breath.<ref name="AABB2012" /> In cases where patients have low levels of hemoglobin due to iron deficiency, but are cardiovascularly stable, oral or [[parenteral iron]] is a preferred option based on both efficacy and safety.<ref>{{cite journal | vauthors = Gasche C, Berstad A, Befrits R, Beglinger C, Dignass A, Erichsen K, Gomollon F, Hjortswang H, Koutroubakis I, Kulnigg S, Oldenburg B, Rampton D, Schroeder O, Stein J, Travis S, Van Assche G | display-authors = 6 | title = Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases | journal = Inflammatory Bowel Diseases | volume = 13 | issue = 12 | pages = 1545–53 | date = December 2007 | pmid = 17985376 | doi = 10.1002/ibd.20285 | url = http://www.gasche.at/pdf/IBD_Journal_2007.pdf | url-status = live | doi-access = free | archive-url = https://ghostarchive.org/archive/20221009/http://www.gasche.at/pdf/IBD_Journal_2007.pdf | archive-date = 2022-10-09 }}</ref> Other blood products are given where appropriate, e.g., [[fresh frozen plasma]] to treat clotting deficiencies and [[platelets]] to treat or prevent bleeding in thrombocytopenic patients.