Blood products: Difference between revisions
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== | ==Packed Red Blood Cells== | ||
=== | ===Features=== | ||
#Can give type O Rh-positive pRBCs to a man or woman no longer of child-bearing age | |||
#Options: | |||
###Leukocyte reduced | |||
####Eliminates 70-85% of leukocytes | |||
####Reduces nonhemolytic febrile reactions | |||
####Prevents sensitization in pts who may require bone marrow transplant | |||
####Minimizes risk of HIV and CMV infection | |||
###Irradiated | |||
####Eliminates capacity of T-cells to proliferate (prevents graft-versus-host disease) | |||
####Consider in transplant pts, neonates and immunocompromised pts | |||
###Washed | |||
####Indicated for pts w/ hypersensitivity to plasma (such as IgA deficiency) | |||
===Indications | ===Indications=== | ||
# | #Acute hemorrhage or chronic anemia with Hb <6 | ||
# | #Symptomatic anemia or cardiopulmonary disease AND Hb <10 | ||
# | |||
===Dose=== | |||
#One unit (250mL) raises hemoglobin by 1 g/dl | |||
##Usually transfuse at least 2 units at a time (15mL/kg in peds) | |||
#Must transfuse no slower than 1 unit/4hr | |||
##If require slower transfusion (e.g. risk for volume overload) the pRBC can be split | |||
==Platelets== | |||
===Features=== | |||
#Transfusion should be type specific b/c platelets are bathed in plasma | |||
##Non-type specific plts can be used but results in higher rate of complications | |||
#Like pRBCs, plts can be leukocyte reduced or washed | |||
===Indications=== | |||
#Plt count <10K in asymptomatic patients (unless due to ITP, TTP, or HIT) | |||
#Plt count <15K with a coagulation disorder or minor bleeding | |||
#Plt count <20K with major bleeding | |||
#Plt count <50K with need for invasive procedure or surgery | |||
#Plt count <100K with need for neurologic or cardiac surgery | |||
== | ===Dose=== | ||
=== | #1 unit raises count by 50K | ||
# | |||
# | ==Fresh Frozen Plasma== | ||
# | ===Features=== | ||
#Contains all coagulation factors and fibrinogen | |||
##40 mL/kg raises any factor by 100% (each unit is ~200mL) | |||
#May cause fluid overload | |||
#ABO compatibilty a must but crossmatch before transfusing not | |||
#INR of FFP is ~1.2 | |||
===Indications=== | ===Indications=== | ||
# | #Rapid reversal of warfarin over-anticoagulation | ||
# | #Bleeding and multiple coagulation defects | ||
# | #Correction of coagulation defects for which no specific factor is available | ||
# | #Transfusion of more than one blood volume w/ evidence of active bleeding + coagulopathy | ||
== | ===Dose=== | ||
=== | #Transfuse at least 15 mL/kg at a time (4 units in 70-kg adult) | ||
# | |||
#1 | ==Cryoprecipitate== | ||
===Features=== | |||
#Cold insoluble protein fraction of FFP | |||
#Contains: fibrinogen, vWF, and factor VIII | |||
#1 bag (10ml) has 50-500 units of factor 8 activity | |||
===Indications=== | ===Indications=== | ||
#Bleeding with fibrinogen level of <100 milligrams/dL | |||
#Dysfibrinogenemia | |||
#Bleeding in vWD that is unresponsive to ddAVP and Factor VIII is unavailable | |||
===Dose=== | |||
#1 unit/5kg (usually 10 units are given at a time) | |||
##Each unit raises the fibrinogen level by 75) | |||
== | ==See Also== | ||
*[[Transfusion Reactions]] | |||
==Source == | ==Source== | ||
Tintinalli | |||
[[Category:Drugs]] | |||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] |
Revision as of 05:27, 21 October 2011
Packed Red Blood Cells
Features
- Can give type O Rh-positive pRBCs to a man or woman no longer of child-bearing age
- Options:
- Leukocyte reduced
- Eliminates 70-85% of leukocytes
- Reduces nonhemolytic febrile reactions
- Prevents sensitization in pts who may require bone marrow transplant
- Minimizes risk of HIV and CMV infection
- Irradiated
- Eliminates capacity of T-cells to proliferate (prevents graft-versus-host disease)
- Consider in transplant pts, neonates and immunocompromised pts
- Washed
- Indicated for pts w/ hypersensitivity to plasma (such as IgA deficiency)
- Leukocyte reduced
Indications
- Acute hemorrhage or chronic anemia with Hb <6
- Symptomatic anemia or cardiopulmonary disease AND Hb <10
Dose
- One unit (250mL) raises hemoglobin by 1 g/dl
- Usually transfuse at least 2 units at a time (15mL/kg in peds)
- Must transfuse no slower than 1 unit/4hr
- If require slower transfusion (e.g. risk for volume overload) the pRBC can be split
Platelets
Features
- Transfusion should be type specific b/c platelets are bathed in plasma
- Non-type specific plts can be used but results in higher rate of complications
- Like pRBCs, plts can be leukocyte reduced or washed
Indications
- Plt count <10K in asymptomatic patients (unless due to ITP, TTP, or HIT)
- Plt count <15K with a coagulation disorder or minor bleeding
- Plt count <20K with major bleeding
- Plt count <50K with need for invasive procedure or surgery
- Plt count <100K with need for neurologic or cardiac surgery
Dose
- 1 unit raises count by 50K
Fresh Frozen Plasma
Features
- Contains all coagulation factors and fibrinogen
- 40 mL/kg raises any factor by 100% (each unit is ~200mL)
- May cause fluid overload
- ABO compatibilty a must but crossmatch before transfusing not
- INR of FFP is ~1.2
Indications
- Rapid reversal of warfarin over-anticoagulation
- Bleeding and multiple coagulation defects
- Correction of coagulation defects for which no specific factor is available
- Transfusion of more than one blood volume w/ evidence of active bleeding + coagulopathy
Dose
- Transfuse at least 15 mL/kg at a time (4 units in 70-kg adult)
Cryoprecipitate
Features
- Cold insoluble protein fraction of FFP
- Contains: fibrinogen, vWF, and factor VIII
- 1 bag (10ml) has 50-500 units of factor 8 activity
Indications
- Bleeding with fibrinogen level of <100 milligrams/dL
- Dysfibrinogenemia
- Bleeding in vWD that is unresponsive to ddAVP and Factor VIII is unavailable
Dose
- 1 unit/5kg (usually 10 units are given at a time)
- Each unit raises the fibrinogen level by 75)
See Also
Source
Tintinalli