Word: triggers
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While donor blood alone may not be directly responsible for this added risk, those percentages had already been disturbing enough to persuade physicians to change what is known as their transfusion trigger. As a rule, they introduced donated blood as soon as the patient's hematocrit--a measure of the proportion of the blood made up of oxygen-carrying red cells--fell below the normal range of 45%-55%. Lately, however, they have begun waiting until it drops to less than 30% before transfusing...
...study makes this revised standard look all the smarter. "There is still a lot of controversy about the trigger," says Dr. Lynne Uhl, a transfusion specialist at Beth Israel Deaconess Hospital in Boston. "But the growing data have reinforced the practice that it's O.K. to let the patient's hematocrit drop lower before transfusing...
...concerns. If a woman complains of chest pain, for example, but says it only bothers her when she's feeling "worked up" - but not on the treadmill or climbing a flight of stairs - her physician should interpret her emotional state as a real, physical risk factor, says Brotman. "The trigger is emotional, and physicians tend to blow that off," he says. "Traditional Western medicine has really endeavored to think of the body as a machine, and disease as how the machine breaks down. [Doctors can be] reluctant to think of the mind and body as being part of that same...
Blood transfusions alone may not be directly responsible for these health hazards, but data from other recent studies have been enough to convince physicians to change their so-called transfusion trigger. Doctors have traditionally waited until the patient's hematocrit - the proportion of the blood made up of red blood cells - drops below the normal range of 45% to 55% before transfusing. Now, doctors prefer to wait longer, until it falls below 30%. "There is still a lot of controversy about the trigger," says Dr. Lynne Uhl, a transfusion specialist at Beth Israel Deaconess Hospital, "but the growing data...
...enrichment - have postponed discussion of further sanctions. The option of military strikes to stop Iran's nuclear activities, while kept "on the table" by the Administration - and loudly championed by its more hawkish associates - remains prohibitive in light of the uncertain prospects of success and the backlash it would trigger. And many old diplomatic hands in Washington and in allied capitals have long argued that the matter can only be settled by a "grand bargain" of the sort now in process with North Korea...