Equilibration of hemoglobin after transfusion

When we are actively transfusing a patient, how soon can we draw a hemoglobin to determine the appropriateness of the response?

Dr. Monika Krezalek provided the following article that statesthe hemoglobin equilibrates reliably as early as 15 minutes.

Early changes in hemoglobin and hematocrit levels after packed red cell transfusion in patients with acute anemia

J. Ignasi Elizalde MD†, Josefina Clemente RN Staff Nurse‡, José Luis Marín MD Assistant Professor§, Julian Panés MD Assistant Professor¶, Blanca Aragón RN Staff Nurse‖, Antoni Mas MD Assistant Chief Professor††, Josep M. Piqué MD Assistant Chief Professor‡‡, Josep Terés MD Chief Professor§§

Transfusion
Volume 37, Issue 6, pages 573–576, June 1997

BACKGROUND: Equilibration of hemoglobin concentration after transfusion has been estimated to take about 24 hours, but some studies have shown that earlier measurements reflect steady-state values in persons who have not bled recently. This study was aimed at assessing the changes over time in hemoglobin concentration after transfusion in acutely anemic patients because of recent bleeding. STUDY DESIGN AND METHODS: Thirty-two normovolemic patients recovering from an acute bleeding episode who were no longer thought to be bleeding and who received a 2- unit red cell transfusion were studied. At baseline and 15, 30, 60, and 120 minutes and 24 hours after transfusion, hemoglobin concentration and hematocrit values were measured. RESULTS: The administration of 2 units of packed red cells elicited a 24-hour increase of 22.4 +/− 6.8 g per L in hemoglobin concentration. Hemoglobin values were not different at any of the defined posttransfusion times. Hematocrit levels experienced similar changes over time. Agreement between 15-minute and 24-hour values was excellent, as only 6 percent of patients exhibited a clinically significant difference (> 6 g/L) between the hemoglobin measurements. CONCLUSION: Hemoglobin and hematocrit values rapidly equilibrate after transfusion in normovolemic patients who are recovering from an acute bleeding episode. This fact would allow a rapid assessment of the effects of transfusion and of the recurrence of bleeding in patients remaining at risk.