A pilot study of the possibility and the feasibility of haemoglobin dosing with red blood cells transfusion.

The present study describes a model to predict a patient’s hemoglobin (Hb) increment after transfusion of 1 or more RBC units with a known Hb content.

The pilot study has, unfortunately, several limitations:
1) A low number of transfusions (n = 52) were evaluated in 27 women and 25 men.
2) The number of units transfused ranged from 1 to 3. Therefore, it is not clear whether the model works if a larger number of RBCs (e.g. massive transfusion) are transfused.
3) Nadler’s formula is the standard for blood volume calculation.
4) The minimum Hb content of a RBC unit is 40 g according to blood transfusion guidelines. There was at least one unit (38.7 g) used in the study that did not meet international quality standards. Why was this unit not discarded?
5) Quality control of ALL RBC units is cumbersome and labor-intensive, as discussed by the authors. Therefore, it cannot be done in the millions of RBCs collected every year. Current guidelines require quality controls in at least 1% of the monthly production.

– Rainer Moog