8. Transfusion therapy Flashcards
Routine AS RBC units are —- mL and have —% Hct
350 mL
60%
RBC increment
1 unit should increase Hgb 1 g/dL
apheresis unit platelet ct
3 x 10^11
random pooled unit platelet ct and dose
5 x 10^10
one dose is 6-10 units
platelet increment
1 unit should increase platelet count by 30-50,000
> 50,000 platelets
bleeding with procedure or trauma is unlikely
10-50,000 platelets
spontaneous bleed unlikely, likely with procedure or trauma
5-10,000 platelets
risk for spontaneous bleed
<5000 platelets
high risk for spontaneous bleed
platelet refractoriness
at least 2 transfusions fail to achieve ⅓ to ½ of expected increment
FFP increment
initial dose of 10-20 mL/kg expected to raise coagulation factors in a nonbleeding patient by 25-50%
—- FFP units usually control hemostasis
4-6
8-15 mL cryo contains…
150-250 mg fibrinogen
cryo increment
1 unit/10 kg expected to increase fibrinogen by 50 mg/dL if there is no ongoing consumption
usual cryo dose
10 units pooled
massive transfusion definition
replacement of patient’s total blood volume or more within 24 hours (8-10 units)
OR acute administration of 4-5 pRBC units in one hour
blood is drawn and stored prior to anticipated need; at least 72 hours before surgery
preoperative collection
blood is collected at the start of surgery and infused during or at the end; can contribute to decreased surgical bleeding by reducing hematocrit
acute normovolemic hemodiluation
shed blood is recovered from surgical field and then infused; surgical site cannot be abdominal due to bacterial contamination
intraoperative collection
blood is collected from drainage devices and infused
postoperative collection
