The Bloody Truth Blog
Anemia management in ESRD: On the horns of a dilemma
May 16, 2012
Recently, I have had several queries and personal communications regarding a perceived increase in RBC transfusions for patients with end-stage renal disease (ESRD) on dialysis. The literature is replete with articles surrounding the management of anemia in this patient population, particularly involving the use of erythropoietin-stimulating agents (ESAs). The literature is limited, however, when it comes to clear guidelines for transfusion. In fact, transfusion is most often discouraged in this population if, in particular, the patient is awaiting a transplant where alloimmunization must be avoided.
The Bloody Truth: Ten Facts About Blood Transfusions
Critical Information Every Physician, Nurse, and Hospital Executive Should Know
Upcoming Webinar
Blood Management Communication and Awareness Strategies
Presented by:
Elora Thorpe, RN, MSN
Transfusion Safety Nurse Manager
The University of Kansas Hospital
June 7, 2012, 2 - 3PM ET
Why the need for blood management?
Transfusion Therapy is Hazardous and Expensive, Yet Blood Utilization is Suboptimal!
- Blood acquisition costs have more than doubled in the past few years and will continue to rise as the blood supply struggles to meet the increasing demand.
- Each transfusion causes a stepwise increase in serious complications including postoperative infection rates, ventilator-acquired pneumonia, central line sepsis, ICU and hospital length of stay, as well as mortality rates.
- Transfusion costs exceed blood acquisition costs by five times or greater when accounting for labor, supplies, administration and adverse events.
- Most physicians who order blood products lack formal training in transfusion therapy, and many are unaware of current transfusion guidelines.
- Oversight of blood utilization is lacking as witnessed by wide variation in transfusion practices between institutions and among physicians at the same institution.
- From a medical-legal standpoint, the financial liability of improper informed consent, inappropriate transfusions and transfusion errors can be substantial.






