This is the podcast, Surgery I See Rounds.

My name's Jeff Guy.

Every day this week this week, I've received an email and a text page several times a day,

learning those of us who practice medicine at my hospital, there is a critical blood shortage.

This typically occurs at the summertime when most people who donate blood that as students are at home or away or at vacation, and blood banks and trauma centers find

themselves every year at this time in an absolute crunch to maintain adequate levels of blood

to deal with emergencies as well as deal with an elective surgery. The pages and emails that I've received have been to remind clinicians only to use

blood products as necessary.

And this has really alarmed me to some degree, thinking that people perhaps are using blood

products if they're not necessary.

And that only should we evaluate our indications or thresholds

for transfusion of blood during times of shortages.

It's my considered opinion that we should consider every unit of blood

under great consideration and only give blood when we deem it

absolutely necessary. So the topic of this podcast is blood conservation in patients in the

intensive care unit. What are our transfusion thresholds if we still use that draconian term?

And what are some of the roles of these

medications that help magically stimulate the production of blood? Anemia is a common occurrence in

critically ill patients, and by the third day of ICU emissions, almost 95% of patients have

some element of anemia. Corwin has written a significant volume of literature on this,

going back to Critical Care Medicine in 1999, Journal of Critical Care Medicine 2001 and Critical Care

Medicine in 2004. This anemia that these critically ill patients have will persist throughout

...