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April 1966

Partial Exchange Transfusion in Severe Chronic Anemia

Arch Intern Med. 1966;117(4):478-479. doi:10.1001/archinte.1966.03870100006002

It is foolish to transfuse a patient without blood letting, because this would not reduce the strain on the body.

Entyphronus, 17th Century.

The HE THERAPEUTIC dilemma presented by the chronically anemic patient was described and a solution offered in the 17th Century.1 Our experiences with three consecutive cases (Table, cases 1-3) in 1958 were consistent with the impression of others: (1) Blood transfusions often are necessary;2,3 (2) fatal pulmonary edema may then follow.4-6 Partial exchange transfusion has offered a belated, simple, and effective solution.

Materials  All adult patients seen by the hematology service of the San Diego Naval Hospital, California, between the years 1959 and 1964, were selected for treatment if they met the following criteria: (1) admission hematocrit level below 12%, (2) no prior blood replacement, (3) no evidence for significant acute blood loss, and (4) the presence of advanced age, cardiac failure, need for