Q: My 59 years old mother is anaemic with a haemoglobin level of just 6 g/dl. The doctor has asked for blood transfusion. Please suggest how many units of blood should be transfused to her. She underwent angioplasty three years back.

A:Anaemia is a condition in which the number of red blood cells or the amount of haemoglobin is below normal for age and sex of the individual. It is defined as a decrease in red blood cell (RBC) mass and is usually discovered and quantified by measurement of the RBC count, haemoglobin (Hb) concentration, and hematocrit (Hct). Anaemia is suggested in females with Hb levels less than 12.0 g/dl (less than 11.5 g/dl in pregnant women). It may be due to decreased production of red blood cells, blood loss (hemorrhage) or red cell breakdown (hemolysis). Anaemia is a symptom of disease (not a disease) that requires investigation to determine the underlying cause. It is twice as common in women than in men, especially during the childbearing years due to menstrual blood loss and pregnancies. One of the commonest cause of anaemia in our country is nutritional deficiency - iron deficiency &/or folic acid/vitamin B12 deficiency. For the evaluation of anaemia, a complete blood count (which includes the red cell indices), a reticulocyte count and a peripheral smear examination are done initially. These tests are able to quantify the severity of anaemia and give a clue to the underlying cause on the basis of which further investigations (if needed) are planned. Packed cell transfusions are given only as an emergency measure and this is not an alternative to treatment for the underlying condition giving rise to anaemia. The amount transfused is calculated based on the weight of the patient, the patients packed cell volume (PCV), the desired PCV and presence or absence of concomitant disease. Your treating physician would be best placed to advise you.