Blood Products

Blood Products

Written by Dr Andrew Lam

Blood Products and Haemorrhagic Shock

PRBC’s

Isolated from whole blood through centrifuge

Transfusion should be individual based. But generally:

1.  Hb <70
2. Concurrent cardiovascular disease + Hb <80

FFP

Contains all coagulation factors – primarily 2, 7, 9 and 10

Dose: 15ml/kg

Indicated in:

• Bleeding with associated factor deficiencies

• Warfarin reversal  

• DIC

Platelets

Separated from whole blood – often pooled from multiple blood donations

Transfuse if:

PLT < 10
PLT < 20 with risk factors
PLT < 50 for most surgical procedures or acutely bleeding
PLT < 100 for neurosurgical procedure

Cryoprecipitate

Derived from plasma – contains concentrated amount of von-willebrand factor, fibrinogen and Factors 8 and 11

Usually used in patients with fibrinogen or VWf deficiencies

Generally aim for fibrinogen > 1 at least

Massive Transfusion

Defined as replacement of either:

• Full blood volume in 24 hours
• >50% of blood volume in 4 hours

Each facility will have their own protocol for massive transfusion, but contains varying combinations of PRBC’s, FFP, platelets and Cryoprecipitate

Consequences of massive transfusion can include:

• Fluid overload 
• Hypothermia
• Hyperkalemia
• Lactic acidosis 
• Hypocalcemia