#96 The Hgb bump: Mind the Gap Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 5 January 2022

⏱️ 19 minutes

🔗️ Recording | iTunes | RSS

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Summary

Have you ever thought about where the 1g/dL hemoglobin appropriate bump after 1 unit of pRBC transfusion? How does the patient's intravascular volume affect this? What rise in hemoglobin should you expect? What factors can impact this?Show notes, Transcript and References: https://www.coreimpodcast.com/2022/01/05/1-to-1-prbc-bump…-the-gap-segment/ (https://www.coreimpodcast.com/2022/01/05/1-to-1-prbc-bump-mind-the-gap-segment/)Time stamps* 01:22 Unpacking the question * 01:55 The math * 04:32 Functional hemoglobin* 08:50 Donor and Patient * 11:18 Scenarios* 12:58 Summary* 14:34 Clarification Tags: IM Core, CoreIM, hemoglobin, intravascular volume, irradiation, donation Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	Welcome to Mind the God, where we break down some common dogmas and dive deeper into things we may take for granted.
0:07.0	This is Dr. Shreya Trevetti, a hospitalist at Bethio Deaconis Medical Center.
0:11.0	And I'm Dr. Jason Freed, a hematologist at Bethzial Deaconis Medical Center. And I'm Dr. Jason Friede, a hematologist
0:14.0	at Bethzial Deaconis Medical Center.
0:16.7	Jason, I got a question on rounds today
0:19.2	by one of my senior residents, and I actually
0:21.6	didn't know where to even look up this answer.
0:24.0	So naturally I came to you.
0:26.0	It's not technically a heim question, but I figured it's up your alley.
0:30.0	Shraya, you know I love questions that are hard to Google,
0:32.0	because there's so few of them these days.
0:34.3	So I'm intrigued.
0:35.3	Yeah.
0:36.3	What was a question?
0:37.3	Okay, so we had this patient who required a transfusion and his hemoglobin didn't bump up the next day.
0:43.0	So we got into this whole discussion
0:45.0	how we're often taught that the hemoglobin should go up
0:48.0	by one gram per desk leader, or if you're in Canada,
0:50.0	10 grams per leader.
0:52.0	I didn't even know where this comes from or if that's actually
0:55.1	even true. Right, this idea that hemoglobin should always bump up by one gram per
1:00.0	desalator from one unit of red cells seems like such a convenient thing like almost too
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