Efficacy of packed red cell transfusion in nutritional anemia patients in a rural tertiary care centre: A cross sectional study

Background: Nutritional anemia is the commonest type of anemia in India, especially in rural areas. Patients with hemoglobin below 6 gm/dl usually require transfusion therapy. In stabilized patients with hemoglobin values between 6 and 10 gm/dl, the decision to transfuse is based on an evaluation of clinical status. Patients with values above 10 gm/dl rarely require transfusion. Initially, whole blood was transfused due to the activity of 2,3 DPG. However, now it is replaced by packed red cells after the advent of proper refrigeration, component separation method, and anticoagulants, especially additive solution SAGM and polyvinyl chloride blood bags.
Aims: 1) To know the efficacy of packed red cell transfusion in symptomatic nutritional anemia patients. 2) If there is a failure of improvement following packed red cells transfusion, the underlying cause of anemia will be evaluated, which may influence the outcome of the transfusion.
Materials and Methods: The present study comprised 110 nutritional anemia patients who received packed red cell transfusion in Sri Manakula Vinayagar Medical College and Hospital. Data were collected for eight months. A thorough clinical examination and history were taken for all 110 patients, and hematological parameters were collected from the automated cell counter.
Results: In the present study, 110 patients with nutritional anemia who underwent packed red cell transfusion were taken. Out of which, 90 patients had features of only iron deficiency anemia, and 20 had features of anemia of combined deficiency (iron, vitamin B12, and folic acid). Iron deficiency anemia is more prevalent in the third and fourth decades. Anemia of combined deficiency in the sixth and seventh decade. Conclusion: Packed red cell transfusions are reserved for anemia patients whose organs (brain, heart) are being deprived of oxygen due to severe anemia and for people whose hemoglobin or hematocrit level is very low. In chronic anemia, there are increases in the content of 2,3-DPG in the red blood cells, with a shift towards the right in the hemoglobin dissociation curve in the cardiac output and respiratory rate. Hence transfusion is rarely indicated. The mean increase in Hb and PCV values in nutritional anemia patients was statistically more significant (p value<0.05). Hence Hb and PCV can be valuable tools in post-transfusion clinical assessment.