hg after blood transfusion

TX RN · Jan 3, 2008

In my past experience I've seen that usually it's a 1:1 ratio, meaning 1 unit of PRBC's increases the Hgb by 1 point. Some other factors can skew that number though, was the patient adequately hydrated? Hemodilution and Hemoconcentration can be culprits in that lab error. I guess maybe patient height and weight can also be a factor here.

MAISY, RN-ER, BSN, RN · Jan 3, 2008

I agree with 1:1 ratio....that's what I've heard too.

However, labs may be different due to original blood draw style. We have been told that drawing blood through an iv site causes breakdown and a diluted value...so it is possible to use a butterfly later and have a much higher hgb if the original hgb was drawn through iv or central line sites...due to dilution.

Maisy;)

Bumashes, MSN, APRN, NP · Jan 4, 2008

How much can a pt.'s hg level rise after two units of PRBC? I had a pt. go from 9 to 13, can that be? Usually it seems to go up only by about 2. Has anyone seen big jumps like this after a transfusion?

We are taught in school that for each unit of blood you get an increase of 1 Hgb and 3% Hct. So, according to my school, your pt should have gone from 9 Hgb to 11 Hgb. However, as is almost always the case, what I've learned in school doesn't always bear up under actual field experience.

core0 · Jan 4, 2008

How much can a pt.'s hg level rise after two units of PRBC? I had a pt. go from 9 to 13, can that be? Usually it seems to go up only by about 2. Has anyone seen big jumps like this after a transfusion?

Was the patient also losing fluids? Hemaglobin measures the amount of hemoglobin in a given volume of blood. If you have decreased volume (for example if the patient is vomiting or having diarrhea) then the hemoglobin will increase. You see the opposite effect when you hydrate someone (you see a sudden drop in hemoglobin).

David Carpenter, PA-C