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Dr. Luis Agote (2nd from right) overseeing one of the first safe
and effective blood transfusions in 1914
• In the 1930’s and 1940’s Dr Charles Drew’s research led
to discovery that blood could be separated into plasma
and red blood cells.
Indications for blood transfusion
• ANEMIA: A decrease in red blood cells (rbc’s) secondary to blood
loss or deficient production
• Normal Hgb Levels
• Males: 14-18 g/dl
• Females 12-16 g /dl
• OR
• If patient is symptomatic
• Effects of Anemia and decreased O2 delivery:
• Tachycardia, dyspnea, palpitations, fatigue, weakness, light
headedness
• If severe, anemia could lead to:
• CVA, or MI secondary to decreased perfusion to heart and
brain
• Causes of Anemia
• Sudden blood loss
• Chronic bleeding
• Phlebotomy in critically ill patients (increases with blood draws 3 x
greater in ICU patients)
• Whole Blood
• Packed Red Blood Cells (prbc’s)
• Platelets
• Fresh Frozen Plasma (FFP)
• Cryoprecipitate
• Rarely used in the US
• Restores fluid volume and circulation
• Contains rbc’s, wbc’s plasma and platelets
• Most common transfusion
• Restores blood’s ability to carry O2
• Contains few platelets and wbc’s
• Generally 250- 350 mls per unit
• Transfuse over 2-4 hours: based on pts need to receive
blood and pts other issues
• Shorter transfusion time: symptomatic
• Longer transfusion time: CHF, ESRD
• Increases the Hgb 1 g/Hct 3-4 %
• Shelf life 42 days
• Platelets are thrombocytes
• Restores clotting ability
• Usual dose is 5-10 units
• OK for rapid transfusion (1 unit over 10 min)
• Increases platelet count by 5000 per one unit
• 4-5 day shelf life
• Unconcentrated source of all clotting factors and
proteins from a single unit of blood (contains
albumin, fibrinogen, and antibodies)
• Treats bleeding caused by factor deficiencies and for
Liver failure, DIC, and reversal of coumadin/warfarin
therapy
• Is frozen and can be stored for up to 1 year
• Notify blood bank 30 minutes prior to when needed
in order for them to thaw the FFP
• After thawing by blood blank must infuse within 6
hours
• Generally 250-300 ml per unit ordered
• OK for rapid transfusion (1 unit over 10 min)
• Concentrate of 4 clotting factors from FFP. Usually used
for patients with specific bleeding disorders sucha as
hemophilia, von Willibrands disease.
• Storage and usage same as for FFP
• A+
• B+
• AB+
• O+
• A-
• B-
• AB-
• 0-
• Universal Donor O- (only 6.6% of the population)
• Hepatitis B - 1: 200,000