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 ?
For these patients, active bleeding due to solid organ injury accounts for the majority of traumatic deaths (2).
Patients who were having active bleeding from nose.
After informed consent the individual patients 15 years of age and above were examined for hemodynamic instability, active bleeding, myocardial ischemia or severe hypoxemia, the indication and type blood product used was noted.
Therapeutic angiography revealed active bleeding from an arteriovenous malformation; hemostasis was achieved after coil embolization of the ileocolic branch.
Esophagogastroduodenoscopy revealed no evidence of active bleeding and colonoscopy revealed no pathology.
On physical exam, the entry wound was at the left side of the thyroid cartilage and the exit wound in the right latissimus dorsi around 5 cm from the mid-line, no active bleeding and ET tube sutured to the left side of the neck (fig 1), no jugular veins distention, no signs of expanding hematoma, good bilateral air entry with normal saturation.
No other source of active bleeding in the abdomen and no signs of ectopic pregnancy were found.
On the 9th day of admission, angiography was arranged due to active bleeding. It showed bleeding point from the superior vena cava area, near the right atrium.
There was no active bleeding, allowing the hospital time to get personnel in place for a removal surgery on Sunday morning that was complicated by the fact that the skewer wasn't round.
A follow-up CT scan showed right-sided perirenal haemorrhage without any evidence of active bleeding during the arterial phase (Figure-3).
Capsule endoscopy confirmed proliferative foci and active bleeding in the ileum.
The cause of the death is attributed to head injury as there was active bleeding from the ear.