Abstract

BROME URIBE, AP; ROLDAN TABARES, MD; HERRERA ALMANZA, L  and  MARTINEZ-SANCHEZ, LM. Transfusions at the end of life. Review of some important considerations. Rev. Soc. Esp. Dolor [online]. 2021, vol.28, n.1, pp.47-52.  Epub Mar 29, 2021. ISSN 1134-8046.  https://dx.doi.org/10.20986/resed.2021.3831/2020.

Transfusion of blood products is used more frequently in patients with hematological malignancies than in patients with solid tumors, and variably in the case of terminally ill patients with other types of pathologies. Anemia and thrombocytopenia are frequent in this diverse group of patients, who receive treatments until the end of life, the transfusion of blood components, such as red blood cells or platelets, being a necessary intervention for the relief of symptoms and improvements in condition. clinical. However, in terminally ill patients, symptoms are multifactorial in origin and hematological values do not necessarily become a criterion for transfusing, however, the scientific evidence supporting that transfusions significantly improve the symptoms of palliative patients has not yet is conclusive.

Although the literature defines some indications for transfusing difficulties, they begin in the context of the selection of the type of transfusion, the amount of the transfusion, and the end of life. In the scientific literature there are different reports that list the last units of blood products administered, prior to the death of the patient; however, little is found in relation to uniform criteria that support the decision at the end of life and the risk benefit ratio is not clear.

Blood transfusions, in addition to being common procedures in clinical practice, are therapies that generate considerable risks and costs for the system, so the search for alternative options becomes imperative when it comes to avoiding unnecessary therapies.

Patients with end-of-life transfusion needs generally have a history of known chronic disease; It is for this reason that the mobilization of individual and family resources becomes the challenge for healthcare personnel, since this will largely depend on the way in which the situation is dealt with and the links that are generated, so the approach must be carried out in an interdisciplinary way.

Keywords : Blood transfusion; palliative care; anemia; quality of life.

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