What are common transfusion triggers during or after CABG?

• A. Clinically significant anemia with symptoms or hemodynamic compromise; intraoperative coagulopathy requiring transfusion; thresholds vary, often Hb <7-8 g/dL for stable patients.
• B. Transfuse only if patient requests.
• C. Transfusion is never required.
• D. Hb >15 g/dL is a trigger.

Answer: (A)

Transfusion decisions in CABG are driven by how well the patient tolerates anemia and whether there is active bleeding or a coagulation problem. When anemia is clinically significant—with symptoms such as chest pain, dyspnea, or signs of poor perfusion—or there is hemodynamic compromise, transfusion is needed to restore oxygen delivery. Intraoperative coagulopathy with ongoing bleeding also triggers transfusion to replace lost blood and correct coagulation factors; this often requires a combination of red cells, platelets, and plasma guided by lab tests and point-of-care assays. In stable patients, a common reference threshold for red blood cell transfusion is around hemoglobin 7–8 g/dL, though the exact target varies with factors like ischemic heart disease or other comorbidities. Transfusion solely for patient requests or for Hb levels well above normal (for example, Hb >15 g/dL) is not appropriate the bleeding risk and transfusion-related harms must be weighed.