transfusion guidelines

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

Major ↓ in fibrinogen, factor VIII, von Willebrand factor

± in reversible liver disease

Queens Hospital Medical Center, 1990