Abstract：
For many years, physicians\' approach to the transfusion of allogeneic red blood cells (RBC) was not individualized. It was accepted that a hemoglobin concentration (Hb) of less than 10 g/dL was a general transfusion threshold and the majority of patients were transfused immediately. In recent years, there has been increasing evidence that even significantly lower hemoglobin concentrations can be survived in the short term without sequelae. This somehow contradicts the observation that moderate or mild anemia is associated with relevant long-term morbidity and mortality. To resolve this apparent contradiction, it must be recognized that we have to avoid acute anemia or treat it by alternative methods. The aim of this article is to describe the physiological limits of acute anemia, match these considerations with clinical realities, and then present \"patient blood management\" (PBM) as the therapeutic concept that can prevent both anemia and unnecessary transfusion of RBC concentrates in a clinical context, especially in Intensive Care Units (ICU). This treatment concept may prove to be the key to high-quality patient care in the ICU setting in the future.
摘要：
多年来,医师对同种异体红细胞(RBC)的输血方法没有个体化.公认的是，血红蛋白浓度（Hb）低于10g/dL是一般的输血阈值，大多数患者立即输血。近年来,越来越多的证据表明，即使血红蛋白浓度显著降低，也可以在短期内存活下来，而不会留下后遗症。这在某种程度上与中度或轻度贫血与相关的长期发病率和死亡率相关的观察结果相矛盾。为了解决这个明显的矛盾，必须认识到，我们必须避免急性贫血或通过其他方法进行治疗。本文的目的是描述急性贫血的生理极限，将这些考虑与临床现实相匹配，然后提出“患者血液管理”（PBM）作为治疗概念，可以防止贫血和在临床背景下不必要的红细胞浓缩输血，特别是在重症监护病房（ICU）。这种治疗概念可能被证明是未来ICU环境中高质量患者护理的关键。
