Blood products

PRBCs

Usual Dose: 1 U of PRBCs (250 mL or 3 mL/kg in peds) --> incr Hgb ~1.0

Indications (by Hb):

Normal (rarely if >10; almost always if <6)

Critically ill, otherwise healthy (keep > 7-9)

Ischemic heart dz/critically ill age >65 (keep >10)

FFP

Usual Dose: 10-20 ml/kg (average adult = 3-6 units)

• 2 U of FFP (450 mL) should correct most early coagulopathies

• An INR of 2.0 correlates w/ PT 1.5 times nl

Indications:

1) Active bleeding AND PT/PTT >1.5 times nl (INR >2.0)

2) INR >20.0

3) Massive PRBC transfusion (>9 U)

4) DIC not corrected by cryo.

5) Coumadin overdose AND life threat bleed/invasive procedure

Platelets

Usual Dose: 1 U per 10kg (~6-10 U) --> incr plat ~25,000.

• 1 U (25-50 mL = "6-pack") --> incr plat 5-10,000 (adult) or 20,000 (20 kg child)

• Indications: See "HEME: Thrombocytopenia"

Risks

Hep B ~1:100,000

Hep C ~1:1 million

HIV 1:2 million

Source

2/18/06 DONALDSON (addapted from Rosen, Lampe, Charfen)