transfusion guidelines

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transfusion guidelines

Transfusion medicine Guidlelines for use of blood components, which are usually written in a hospital's policy manual. See Transfusion criteria, Transfusion medicine.
Transfusion guidelines, general criteria
Hemoglobin
 < 8g/dL if healthy and stable
 < 11g/dL if Pt is at risk of ischemia
Acute blood loss ≥ 15% (est) blood volume, tachycardia, oliguria
Symptomatic anemia resulting in tachycardia, change in mental status, cardiac ischemia, or SOB Transfusion 1996; 36:144. See Transfusion guidelines.
Packed RBCs  
•  Hemorrhage
•  Active Physiologic instability, including tachycardia, ↓ in systolic BP > 30 mm Hg below baseline, orthostatic hypotension, angina, mental confusion, agitation
•  Chronic Physiologic instability–see above, refractory state.
•  Sickle cell anemia
Refractory crisis, acute lung syndrome, CVA, priapism, hepatic infarct, acute papillary necrosis, general anesthesia, contrast studies
Platelets  
• Platelet count < 30,000/µL
•  Functional platelet deficit
•  Surgical prophylaxis
•  Massive bleeding
Cryoprecipitate  
•  Active bleeding, fibrinogen < 100 mg/dL
•  Massive bleeding
•  DIC w/ bleeding
•  10 fibrinolysis
Dysfibrinogenemia
Majorin fibrinogen, factor VIII, von Willebrand factor
± in reversible liver disease
Queens Hospital Medical Center, 1990
References in periodicals archive ?
To summarize, N-butyl-2-cyanoacrylate sclerotherapy is highly effective for the treatment of active bleeding gastric varices, with 15 Percent complications occurring both acutely and long term.
5) Most emphasize the detection of active bleeding.
Median sternotomy is the approach most commonly utilized as it allows for adequate exposure of the heart and great vessels and can be extended easily for a laparotomy if active bleeding is encountered.
Within 20 minutes of administration, active bleeding was controlled in 440 (90%) of the women in the misoprostol group and 468 (96%) of the women in the oxytocin group.
Failure to identify the fistulous communication during the first three angiographic studies can be attributed to the lack of active bleeding during the study.
Correct technique is important, and while active bleeding is necessary for localisation of the bleeder, excessive bleeding makes visualisation of the specific vessel difficult and prevents effective cautery.
An urgent CT scan of the abdomen with portal venous phase contrast (Figure 1) showed the possibility of haemorrhage in the right iliac fossa with a small area of active bleeding anterolateral to the duodenum and medial to the ascending colon.
Patients were excluded if they were pregnant; were unable to complete follow-up assessments; or had contraindication to subcutaneous therapy, active bleeding, life expectancy less than 3 months, treatment for venous thromboemoblism (VTE) for more than 48 hours, long-term anticoagulation therapy, a contraindication to heparin or radiographic contrast, or creatinine greater than 2.
Capsule endoscopy located active bleeding in 13 of 24 patients, while EGD detected it in2 of 17patients and colonoscopy found it in 0 of 13 patients.
Physical examination revealed active bleeding from the gingiva over the right mandibular molar.