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 ?
More conservative transfusion guidelines could increase the available blood supply with no increase in donations because units saved would be available for other patients, notes Dr.
Existing transfusion guidelines do not give specific hematocrit values at which to consider transfusion for patients with cardiovascular disease, and the use of such transfusion varies from 0.
Most physicians and nurses lack formal training in current transfusion guidelines and best practices.