Shiny K. Kajal: The Shift from Number-Based to Patient-Centered Transfusion
Shiny K. Kajal, Senior Resident at Adesh University, shared a post on LinkedIn:
“Post 35- We don’t transfuse hemoglobin. We transfuse patients.
Yet in daily practice, transfusion decisions are still often reduced to a single number.
- A ‘low’ Hb without symptoms
- An ‘elevated’ INR without bleeding
- A ‘normal’ platelet count without function
These numbers, in isolation, can be misleading—and sometimes harmful.
Before you prescribe blood, ask:
Is this anemia physiologically significant?
Is there evidence of bleeding risk, or just an abnormal lab?
Am I correcting a number… or improving patient outcome?
Because:
- Ferritin guides long-term consequences in repeated transfusions
- INR does not reliably predict bleeding in stable patients
- Platelet count does not reflect platelet function
Transfusion is a clinical decision—not a laboratory reflex.
The shift from number-based to patient-centered transfusion is the essence of modern Patient Blood Management.
Would you transfuse this patient based on Hb alone?
Or do you integrate clinical context and physiology into your decision?”
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