An absolute indication for rapidly correcting anemia by RBC transfusion is:

• A. Restore tissue oxygenation
• B. Limit hyperbilirubinemia
• C. Supplement with blood cells that contain HbA
• D. Increase WBC count

Answer: (A)

Restoring tissue oxygenation is the primary goal of RBC transfusion in anemia. When red cell mass is low, arterial oxygen content falls, reducing oxygen delivery to tissues. Transfusing packed red blood cells increases hemoglobin concentration, boosting the oxygen-carrying capacity (CaO2) and thereby improving oxygen delivery (DO2) to organs. This is the key reason for rapid transfusion in anemic neonates who show signs of poor perfusion or hypoxia.

Bilirubin-related issues are managed with phototherapy or exchange transfusion if needed, not as a direct reason to transfuse to fix anemia. Increasing white blood cell count isn’t a goal of RBC transfusion either. While donor blood contains hemoglobin A, the presence of HbA isn’t the indication for transfusion—the purpose is to raise the oxygen-carrying capacity to prevent tissue hypoxia.