transfusing chronical anemic patients to hemoglobin goal can cause worsening symptoms or even death

A patient may have low hemoglobin from slow bleed but be euvolemic and hemodynamically compensated. Transfusing this patient to goal of hemoglobin 7 in acute setting may cause volume overload. A better strategy is to assess if the patient is bleeding or not first. If there's no acute bleed, transfuse 1u pRBC and reassess volume status, give lasix, before tranfusing more blood.

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