PROCEDURE FOR BLOOD TRANSFUSION IN HEART DISEASE AND IN ELDERLY SUBJECTS: ADMINISTRATION OF SEDIMENTED ERYTHROCYTES WITH PATIENT SITTING UPRIGHT

In situations requiring transfusion of large amounts of blood, a practical difficulty is frequently imposed by associated disorders which restrict the ability of the heart to accommodate to an increased blood volume. Among the latter are various types of heart disease, nephritis, and toxemias of pregnancy and old age, generally, in which cardiac reserve is limited. Shock and anemia of marked degree significantly affect the heart of an aged patient and may cause coronary insufficiency with accompanying myomalacia. 1 Pernicious anemia often affects those of advanced years among whom coronary artery disease is prevalent, and the latter condition necessitates caution if rapid replacement of normal blood values by transfusion is indicated. The frequency of complicating conditions in the administration of transfusions among the various services at the Kings County Hospital has led to the development in the blood bank of a simple procedure that lends itself to universal employment. PROCEDURE