Therapy

• Treat acute GI bleeding (see upper GI bleeding chapter)
• Treat congestive heart failure (see heart failure chapter)
• In general, chronic anaemias do not require transfusion, unless the patient is symptomatic (when blood should be given slowly) ^d
• For normovolaemic critically-ill  patients, aim for a haemoglobin between 7.0 and 9.0 g/dl, transfusing red cells if the level falls below 7.0 g/dl ^a

^{Iron-deficiency anaemia}

• Give iron supplements  ^b e.g. oral ferrous sulphate 200 mg three times a day. ^d Side-effects, including constipation ^b, are common.

^{Macrocytic anaemia}

• Give hydroxycobalamin  ^a 1mg im alternate days for 6 days.  ^d Cobalamin can be given orally ^c but in very high doses and with variable success ^d
• Give folate 5 mg orally once a day ^a

^{Other haematological disorders}

• Discuss with a haematologist ^d