Rishdha Roshad: Hemodilution vs Transfusion on CPB – Balancing Oxygen Delivery and Microcirculatory Flow
Rishdha Roshad, BS Cardiac Perfusion Technology Student at Dow University of Health Sciences, shared a post on LinkedIn:
” ‘Would you transfuse?’
The patient’s hematocrit falls to 22% shortly after initiating cardiopulmonary bypass.
Do you reach for blood?
Or do you pause and assess the bigger picture?
This is where perfusion becomes more than managing a machine.
It becomes the science of interpreting physiology.
A falling hematocrit is expected during CPB as the patient’s blood mixes with the circuit prime. While oxygen-carrying capacity decreases, blood viscosity also falls, which may improve microcirculatory flow and tissue perfusion.
The challenge is recognizing -when hemodilution remains physiologically acceptable—and when it no longer does.
No single number can answer that question.
A hematocrit value gains meaning only when interpreted alongside the patient’s overall physiological status:
- Is oxygen delivery (DO₂) adequate?
- Is pump flow sufficient for the patient’s metabolic demands?
- What is the trend in lactate and acid-base status?
- How is tissue perfusion evolving?
- What is changing – and why?
Perhaps this is one of the greatest lessons in perfusion.
We don’t transfuse because of a number.
We transfuse because the patient’s physiology tells us it is necessary.
Every patient is different.
Every bypass run is different.
And every decision is a balance between preserving oxygen delivery, minimizing unnecessary transfusion, and supporting the physiology of the patient in front of us.
I’d love to hear from the perfusion community:
When faced with a falling hematocrit during CPB, what physiological indicators have the greatest influence on your transfusion decision?
I’m looking forward to learning from your experiences.”
Stay updated with Hemostasis Today.
-
Aug 10, 2026, 13:36Ianalumab and the Changing Landscape of ITP Treatment – ITP Support Association
-
Aug 10, 2026, 13:06Azin Kheirkhah: New Research on OSE-IgM Antibodies and Age-Related Macular Degeneration
-
Aug 10, 2026, 11:20Jean-Jacques Kiladjian: Interferon-Alpha in Polycythemia Vera Balancing Efficacy and Autoimmune Risk
-
Aug 10, 2026, 11:15Julie McMullen: CSANZ Heart Failure Stream – Latest Updates on Atrial Myopathy and AFib
-
Aug 10, 2026, 11:07Praveen Kaudlay: A Deep Dive into Hemophilia Care Progress with Dr. Suresh Hanagavadi
-
Aug 10, 2026, 10:59Christian Heiss: Paclitaxel Efficacy in Dialysis-Dependent PAD
-
Aug 10, 2026, 10:52Seth Masters: Blocking the Effect of Pyrin by Targeting IL-1
-
Aug 10, 2026, 10:47Sadia Kamal: Making Connections and Sharing Science at Hemostasis GRC
-
Aug 10, 2026, 10:34Ifeanyichukwu Ifechidere: TTP and ADAMTS-13 – The Enzyme Deficiency That Can Kill in 24 Hours