Impact of Erythrocyte Suspension Transfusion and Viscosity on Perfusion Index in the Emergency Department

Objective: Erythrocyte suspension (ES) transfusion is a frequently needed and performed procedure in emergency departments. In this study, the effect of transfusion on the perfusion index (PI), shock index (SI), vital parameters, hemoglobin (Hb), and hematocrit (Hct) values in adult patients who applied to the emergency department and required ES transfusion was investigated.
Material and Methods: Fifty-five adult patients who applied to the emergency medicine clinic within three months and underwent ES replacement were included in the study. The changes in PI, SI, vital parameters, Hb, and Hct values of patients with ES transfusion compared with those pre-transfusion were analyzed.
Results: The mean age of 55 patients included in the study was 62.5±16.5 years, of which 28 (50.9%) were female. Pre-transfusion values of the patients were Hb 6.4±1.2 g/dL, mean arterial pressure (MAP) 83.2±11.6 mmHg, SI 0.73±0. 19, and PI was 3.07±2.21. After the transfusion procedure, Hb was 9.0±1.2 g/dL (p<0.001), MAP 90.0±13.0 mmHg (p<0.001), SI 0.67±0.14 (p=0.003), PI 4.25±3.18 (p=0.004).
Conclusion: The ES transfusion procedure causes a statistically significant increase in post-transfusion PI, MAP, Hb, Hct, and body temperature values compared with pre-transfusion, and a statistically significant decrease in mean pulse and SI. PI can be used as a parameter to evaluate treatment response as well as transfusion decisions in patients.

Keywords: Perfusion index, emergency department, erythrocyte suspension, transfusion, shock index