Blood products
Revision as of 08:02, 5 February 2014 by Rossdonaldson1 (talk | contribs)
Packed Red Blood Cells
Platelet Transfusion
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 Transfusion
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 (can also use Humate-P, FFP doesn't work well)
Dose
- 1 unit/5kg (usually 10 units are given at a time)
- Will raise fibrinogen level by 75
Humate-P
Features
- Contains: vWF and factor VIII
Indications
- Hemophilia A (can also use factor VIII, FFP doesn't work well)
- vWD that is unresponsive to DDAVP (can also use cryo, FFP doesn't work well)
Dose
Depends on condition and severity of bleeding
See Also
Source
Tintinalli