After a PRBC transfusion, which finding best confirms the transfusion was effective?

• A. Increased Hgb and Hct with symptom improvement
• B. Decreased red cell count
• C. Stable hemoglobin level
• D. Development of fever

Answer: (A)

Transfusion effectiveness is shown by restoring the blood’s oxygen-carrying capacity, which is reflected by a rise in red cell mass. The best confirmation after a packed RBC transfusion is an increase in hemoglobin and hematocrit, accompanied by improvement in symptoms such as fatigue or dyspnea. Typically, one unit can raise hemoglobin by about 1 g/dL and hematocrit by a few percentage points, though exact changes vary with blood volume and ongoing losses. Why other signs aren’t the best indicators: a decreased red cell count would suggest ongoing loss or destruction, a stable hemoglobin level means no substantial effect, and developing fever could indicate a transfusion reaction rather than effectiveness.