anemia induced death

Specialties Hospice

Published

Can anyone tell me about what a Hct has to drop to in a bleed out cancer patient before they die? This patient is about 185 lbs. Current Hct is 20.4 and she has elected no further blood transfusions. At this time BP still stable in 120's. No SOB yet either. I'd appreciate any feedback.

ktwlpn, LPN

3,844 Posts

Specializes in LTC,Hospice/palliative care,acute care.
Can anyone tell me about what a Hct has to drop to in a bleed out cancer patient before they die? This patient is about 185 lbs. Current Hct is 20.4 and she has elected no further blood transfusions. At this time BP still stable in 120's. No SOB yet either. I'd appreciate any feedback.
There is a thread in the critical care forum "lowest h and h " Check it out.....
Specializes in Oncology/Haemetology/HIV.

There is no answer to this question.

It is like what level an electrolyte will be at before they die. Books will tell you what is incompatible with life, and you will have patients whose counts routinely defy that level. A chronically anemic patient can survive at much lower levels than someone young and healthy that develops a rapid bleed, and drops quickly at times.

The lowest Hgb that I have dealt with was and elderly lady that drove herself to the ER with a Hgb of 3.4 (I beieve or thereabouts). We transfused her and she was discharged home when stable. That would be HCT of about 10.

A better question, is if this patient is declining transfusions, why are y'all checking H/Hs on them? There is no good reason to, and it really does not provide any accurate barometer of how long that they have.

Overall condition, vital signs, I/O and function is just as good a judgement factor as labs, and less invasive to the patient.

We can not predict time of death by labs anymore than we can predict the weather. There are too many factors involved. I know that patients and family do not like to hear that, but it is true.

Only G-d can predict death with any degree of accuracy.

+ Add a Comment