IBCC Episode 9 - Anemia

In this IBCC podcast episode, Josh and Adam Thomas discuss anemia and transfusion goals in critical care. They outline an approach to dropping hemoglobin in the ICU, emphasizing the importance of focusing on hemolysis and hemorrhage rather than production problems. They address the phenomenon of ICU hemoglobin drift, advising against unnecessary labs and considering proton pump inhibitors. The discussion covers transfusion targets, advocating for a target of 7 for most ICU patients and 8 for those with active myocardial ischemia or post-CABG surgery, while also cautioning against over-transfusion. Specific considerations for Jehovah's Witness patients are addressed, including proactive communication, blood conservation strategies, and promoting blood synthesis with EPO and iron supplementation. The hosts also highlight common pitfalls, such as unnecessary iron studies and over-transfusion, and stress the importance of considering contraindications to transfusion in certain patient populations.