Circulatory haemodynamics after blood transfusion in chronic severe anaemia.

In patients with chronic severe anaemia blood transfusion is often essential and the only life-saving procedure.It provides not only immediate relief of symptoms but prevents potential irreversible anoxic damage to tissues.Several investigators (Drummond, 1943; Sharpey-Schafer, 1945; Fullerton and Turner, 1962; Graettinger, Parsons, and Campbell, 1963) have, however, reported heart failure, pulmonary oedema, and deaths in patients with severe anaemia after transfusion of whole blood as well as of packed red cells, either given rapidly or slowly.It is believed that in anaemic patients the functional capacity of the myocardium may be severely impaired and its reserve powers negligible so that any overloading of circulation may then pre- cipitate heart failure (Drummond, 1943).Dangers of circulatory overloading have therefore been stressed and suggestions have been made regarding the amount and the speed of blood transfusion in anaemic patients (Drummond, 1943; Wintrobe, 1961; Britton, 1963).Reports of effects of blood transfusion on cir- culatory haemodynamics in patients with chronic severe anaemia are few, and the number of patients studied in these reports is small (Sharpey-Schafer, 1945; Regan et al., 1963; Duke, Herbert, and Abelmann, 1964).The present investigation was, therefore, undertaken to determine the haemo- dynamic alterations and possible dangers of cir- culatory overloading after moderately rapid transfusion of whole citrated blood in patients with chronic severe anaemia, including patients with clinical heart failure, cardiac enlargement, or electro- cardiographic abnormalities, and to determine the duration of haemodynamic alterations.