Zusammenfassung
Der Einsatz von Erythrozytenkonzentraten muss dem Gebot einer rationalen Indikation
folgen. Um dies weiter zu gewährleisten, wurden die 2009 publizierten und zuletzt
2014 in Teilen revidierten „Querschnitts-Leitlinien zur Therapie mit Blutkomponenten
und Plasmaderivaten“ [1] der Bundesärztekammer 2020 einer systematischen Novellierung unterzogen. Der Artikel
stellt sie vor.
Abstract
The use of erythrocyte concentrates (EK) must be based on a rational indication. In
order to insure this, the guidelines of the German Medical Association published in
2009 and last revised in part in 2014 were subject to a systematic amendment in 2020.
The clinical studies published in the past few years confirmed the basic statements
of the guidelines on erythrocyte transfusion for an individually adapted but fundamentally
restrictive indication. At the same time, the results of new studies on defined patient
groups made it possible to further individualize the indication for erythrocyte transfusion.
The indication for erythrocyte transfusion must align with the question how it is
possible to compensate for anaemic oxygen deficiency in the individual case. Clinical
symptoms of anaemic hypoxia that occur when the oxygen supply falls below a critical
level (so-called “physiological transfusion triggers”) are the definitive indicators
of erythrocyte transfusion. However,
these are unspecific and cannot always be clearly determined under clinical conditions.
Therefore, the current haemoglobin concentration, the general condition and those
concomitant diseases that limit the individualʼs ability to compensate for anaemia
must be taken into account when setting the individual indication for erythrocyte
transfusion.
Schlüsselwörter
Erythrozytenkonzentrat - Anämie - hypoxische Anämie - Transfusionsindikation - Kompensationsmechanismen
der Anämie
Key words
red cell concentrates - anaemia - hypoxic anaemia - transfusion indication - compensation
mechanisms for anaemia
