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 ?
Participating institutions were asked to complete a questionnaire with 14 additional questions related to plasma transfusion guidelines, compliance monitoring and reporting, number of plasma units transfused in the previous year, plasma wastage rate, massive transfusion protocols, and serious plasma-related transfusion reactions.
Higher rates of pretransfusion coagulation testing tended to occur in institutions that used AABB as a source for developing transfusion guidelines, and lower rates of posttransfusion coagulation testing tended to occur in institutions with the following characteristics: (1) rural location; or (2) where the blood bank supervisor or manager was involved in the development of transfusion guidelines.
According to the transfusion guidelines (2000) issued by the China's Ministry of Health, when Hb >10 g/dl, RBC transfusion was not needed; while when Hb <7 g/dl, transfusion should be considered; when Hb between 1-9 g/dl, the RBC transfusion should be considered according to patients' cardiopulmonary compensatory function, body metabolism, and oxygen consumption.
Different blood transfusion guidelines are introduced in various parts of the world, to specific transfusion of Hb for patients with different levels.
The effects of a selfeducating blood component request form and enforcements of transfusion guidelines on FFP and platelet usage.
Overall, the institutional transfusion guidelines were readily available to ordering physicians in 73% (94 of 129) of the facilities.
Participants reported their sources for transfusion guidelines as follows (multiple answers permitted): journal article(s), 70% (n = 88); professional organization, 63% (n = 79); textbook(s), 62% (n = 78); local expert opinion, 45% (n = 57); local blood donor center, 18% (n = 22); centralized requirements of a health care system, 14% (n = 17); and unknown, 6% (n = 8).
By developing and implementing comprehensive blood management programmes focusing on implementation of evidence-based transfusion guidelines to reduce variability in transfusion practice in hospitals can promote safe and clinically effective blood utilisation.