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Transfusion in elderly patient Volume 18, issue 4, Juillet-Août 2012

Author
Établissement français du sang Auvergne-Loire, 42023 Saint-Étienne ; université de Lyon, faculté de médecine, EA-3064, 42023 Saint-Étienne

There is a sustained increase in the global aging of populations in the Western world, and consequently of aging-associated pathology. The aged present frequently with anemia, that is normochromic and normocytic, and which results from diverse and complex etiologies, of which are the iatrogenic ones; further, the aged frequently fall down and present with bone and joint lesions leading to bleeding surgery; further again, the aged are often treated with anticlotting and antiplatelet drugs with no reevaluation of the needs, that lead to excess bleeding. The aged justify Red Blood Cell component transfusions and impose for a large part the need for increasing the inventory by an additional 2.5 to 3 % every year (imposing a sustained effort on blood collection). Anemia in the aged is frequently bad tolerated or can be accepted because of a context of heart or coronary insufficiency; this renders the transfusion necessary for those reasons, along with oxygenation of any other tissue ad brain for improving cognition. The transfusion act principally differs in the aged because of exacerbated vigilances, sustained efforts for informed consent, environment for delivering the transfusion, and surveillance of overload. It thus appears of particular importance and relevance to be knowledgeable on particularities of transfusion in the aged, due to the yearly increased frequency of such treated patients.