Packed red blood cells
General
- Type: Blood components
- Dosage Forms: IV, IO
- Common Trade Names: N/A
Adult Dosing
- One unit (250mL) raises hemoglobin by 1 g/dl
- Usually transfuse at least 2 units at a time
- Must transfuse no slower than 1 unit/4hr
- If require slower transfusion (e.g. risk for volume overload) the pRBC can be split
Pediatric Dosing
- 15 mL/kg
Special Populations
- Pregnancy Rating: N/A
- Lactation: N/A
- Renal Dosing: N/A
- Hepatic Dosing: N/A
Types
- Leukocyte reduced
- Eliminates 70-85% of leukocytes
- Reduces nonhemolytic febrile reactions
- Prevents sensitization in patients 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 patients, neonates and immunocompromised patients
- Washed
- Indicated for patients with hypersensitivity to plasma (such as IgA deficiency)
Indications
- Hgb <6 g/dL: Recommended except in exceptional circumstances
- Hgb 6 to 7 g/dL: generally likely to be indicated
- Hgb 7 to 8 g/dL: should be considered in postoperative surgical patients, including those with stable cardiovascular disease, after evaluating the patient’s clinical status
- Hgb 8 to 10 g/dL: generally not indicated, but should be considered for some populations (eg, those with symptomatic anemia, ongoing bleeding, acute coronary syndrome with ischemia)
- Hgb >10 g/dL: generally not indicated except in exceptional circumstances
Contraindications
- No absolute contraindications
Adverse Reactions
Serious
- Hypocalcemia due to citrate (massive transfusion protocols) - check ionized calcium levels
Transfusion Reaction Types
- Acute
- Delayed
Common
Pharmacology
- Half-life: N/A
- Metabolism: N/A
- Excretion: N/A
- Mechanism of Action: N/A
Comments
- Can give type O Rh-positive pRBCs to a man or woman no longer of child-bearing age