title: Blood transfusions: for the thermally injured or for the doctor?
abstract: BACKGROUND
  Because of the inherent risks of blood transfusions, including the transmission of viral and other infectious diseases, it is important to re-evaluate blood transfusion policies.
  
  
  METHODS
  The present study compared the results of a new selective transfusion policy in which patients were not transfused unless their hemoglobin levels went below 6-6.5 g/dL versus our previous routine transfusion policy in which the hemoglobin levels were routinely maintained at 10 g/dL. The selectively transfused group consisted of 14 patients with a mean +/- SD burn size of 28% +/- 11%, while the routinely transfused group consisted of 38 clinically comparable patients with a mean burn size of 26% +/- 12%.
  
  
  RESULTS
  The patients managed by selective transfusion received fewer transfusions (2.1 +/- 1.7 units) during their hospital stay than patients transfused routinely (7.4 +/- 7.6 units) (p < 0.007) and were less likely to receive maintenance transfusions (4 of 29 total units versus 116 of 282 total units) (p < 0.004). No adverse hemodynamic or other adverse effects related to limiting blood transfusions in the selectively transfused group was noted.
  
  
  CONCLUSIONS
  Routinely transfused patients, on average, received over 5 units more blood than the selective group without any apparent clinical benefit. Thus, the results of this pilot study support a policy of selective blood transfusions in burn patients.
authors.affiliation: Department of Surgery Louisiana State University Medical Center, Shreveport 71130-3932.
authors.forename: K M
authors.initials: KM
authors.lastname: Sittig
authors.forename: E A
authors.initials: EA
authors.lastname: Deitch
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002056:Burns / Q000097:blood / Q000628:therapy*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005440:Fluid Therapy; D006291:Health Policy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins