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Blood Products

Dr Swapnil Pawar April 11, 2024 8


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    Blood Products
    Dr Swapnil Pawar

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
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