Blood Products


Facts
  • 1 Unit Platelet = 5000/microL
  • 1 Unit PRBC = 1 g/dg Hgb
    • The threshold for transfusion of RBC should be a hgb < 7 g/dL in adults and most children
    • What is normal Hgb level ?
      • African-Americans: Hgb tend to be 1 g/dL lower compared to the other U.S. ethnic groups studied.
      • Living at higher altitudes:
        • +1 g/dL at 1000 meters
        • Up to +5.5 g/dL at 5000 meters.
      • Smoking:
        • increases hemoglobin levels by 3 g/dL for a 1 pack/day smoker
        • +7 g/dL for individuals smoking more than 2 packs/day.
      • Pregnancy: results in a 1.0 - 1.5 g/dL reduction in normal hemoglobin levels.
  • EPO = Increase HCT 4-6% in 4-6 weeks
 

 
Pre-Transfusion meds:
Benadryl 25mg 1 po x 1
PLUS
Tylenol 650mg 1-2 tabs po x 1

PRBC

PACKED RED BLOOD CELLS

Volume:

250-300 mL/unit

Composition:

80 % of the plasma has been removed
Lacks clotting factors and platelets

Indications:

Acute anemia

Dosage:

Each unit should increase hemoglobin by 1g/dL, and hematocrit by 3%

PLATELETS

Volume:

50 mL/unit

Composition:

1 unit represents platelets removed from 1 unit of blood

Indications:

Platelet count < 20,000 in non-bleeding patient

Platelet count < 50,000 before surgery or with active bleeding

Dosage:

1 unit should increased platelet count by 6,000
Adult: 6-10 units
Peds: 5 mL/kg

FRESH FROZEN PLASMA

Volume:

150-200 mL/unit

Composition:

Plasma
Clotting factors II, V, VII, IX, X, XI, XII, XIII

Indications:

Replacement of clotting factors
Bleeding disease of unknown cause
Warfarin overdose associated with severe bleeding

Dosage:

15 mL/kg
Half-life: appx 6 hrs

CRYOPRECIPITATE

Volume:

10 mL

Composition:

von Willebrand's factor
Raises fibrinogen 75 mg/mL

Indications:

Hemophilia A; Von Willebrands disease; Fibrinogen deficiency

Dosage:

Given as pool of 10-20 units
Adult: 10 U IV
Peds: 1 U/5 kg

LEUKOCYTE-POOR RBCs

Volume:

200-250 mL

Composition:

Most WBC’s and platelets have been removed to decrease antigenicity

Indications:

Acute anemia

Dosage:

Previous febrile transfusion reactions, multiple transfusions (leukemia)

WASHED RBCs

Volume:

300 mL

Composition:

All WBC’s have been removed

Indications:

Previous febrile transfusion reactions; multiple transfusions

Dosage:

Each unit should increase hemoglobin by 1g/dL, and hematocrit by 3%

- EPO = increase HCT 4-6% in 4-6 weeks