The tolerance to intra- and post-operative anaemia depends on type and duration of pre-existing anaemia, the patient’s cardiovascular status and the perisurgical blood loss. Serveral surveys found an increased risk of morbidity and mortality in patients with low perioperative haemoglobin levels, especially in combination with cardiovascular diseases. On the other hand a possible beneficial effect of the transfusion of red cells could be detected only in patients without myocardial ischaemia with a transfusion trigger below 6–7 g/dl and in patients with acute myocardial ischaemia with a transfusion trigger over 9–11 g/dl. Further prospective randomised studies with large patient numbers are necessary to find beneficial effects of blood transfusions on post-operative morbidity and mortality at least in subgroups of critically ill patients.
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