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Where does the blood go?

Someone I know and love is in the hospital. He’s doing well, thank you. But I am confused. They have given him 10 pints of blood to help with a blood disease that results in the destruction of red blood cells. Ten pints is a lot. Yet, his blood pressure has remained steady. As you add fluid to a contained system, shouldn’t the pressure increase? He reports that he is not urinating particularly much. So, where is the blood going? Just curious.

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3 Responses to “Where does the blood go?”

  1. Good question for a non-physician! But you are filled with good questions. If he is getting the blood for a lack of red cells, as you suggest, he is probably being given only the red blood cells themselves, not the fluid also. This helps to reduce reactions to the transfusion as well as minimizing the volume problem you guessed about. If a lot of blood fluid is required, diuretics can help get out superfluous liquid and salt. The fluid can be a problem, though, if the patient’s kidneys are unable to excrete the fluid.

    I hope he continues to do well.

  2. Most red bood cells are excreted through the bowels.

  3. If he was dehydrated when he went in, as most humans normally are, a lot of the volume will become part of his body. He’ll gain weight. And exhale some of the water.

    And, as the cells die, the protein they contain is either recycled as tissue, via amino acids, or converted to bilirubin and other waste products by the liver and excreted. In his case, the liver is apparently working too well.

    Ten pints is, what, a little over a gallon? I would imagine he is getting a lot more fluids with IVs; the hospital is (I hope) monitoring his vitals regularly, likely including, considering his problem, his input/output. Any serious imbalance should raise alarms. Normal water loss in a human is 2.5 liters/day, depending on perspiration.

    Unless he chose the low payment HMO, he’ll be fine. Does the staff use cell phones to consult with doctors in a foreign language? Can he read the labels on the drugs? Talk to the staff in any language that he understands? These questions may indicate the need for some caution. :)

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