September 2026
M	T	W	T	F	S	S
	1	2	3	4	5	6
7	8	9	10	11	12	13
14	15	16	17	18	19	20
21	22	23	24	25	26	27
28	29	30

Rishdha Roshad: Hemodilution vs Transfusion on CPB – Balancing Oxygen Delivery and Microcirculatory Flow

Rishdha Roshad/LinkedIn

Aug 10, 2026, 11:19

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.”

Rishdha Roshad