Fresh Frozen Plasma - Indications - ️️- Contains all clotting factors except platelets
and is frozen to preserve factor V and VIII.
- Active bleeding.
- Replacement of plasma coagulation factors when simultaneously blood volume
expansion is required.
- Also has antibodies: helps fighting i...
Blood Transfusion Therapy & Reactions
Fresh Frozen Plasma - Indications - ✔️✔️- Contains all clotting factors except platelets
and is frozen to preserve factor V and VIII.
- Active bleeding.
- Replacement of plasma coagulation factors when simultaneously blood volume
expansion is required.
- Also has antibodies: helps fighting infection
- Can be used to revert the effects of Warfarin before surgery.
Whole Blood - Indications - ✔️✔️- Treatment of acute massive hemorrhage.
- Treatment of patients with active bleeding that have lost more than 25% of their total
blood volume.
- Patients symptomatic for oxygen-carrying deficit capacity AND hypovolemia
associated with shock.
- Patients undergoing cardiopulmonary bypass, intraoperatively and during the first six
hours postoperatively.
What is the critical time-frame for monitoring for transfusion reactions? - ✔️✔️15
minutes after initiating the transfusion.
Types of blood products available for transfusion (7) - ✔️✔️1. Whole Blood
2. Packed Red Blood Cells (PRBC)
3. Platelets
4. Albumin (5% or 25%)
5. Fresh Frozen Plasma (FFP)
6. Cryoprecipitate
7. IVIG (Intravenous Immunoglobulins)
Reasons for blood transfusions (4) - ✔️✔️1. Restore circulating blood volume
(hemorrhage, trauma, surgery, hypovolemic shock, burns)
2. Correct RBC deficiency and improve oxygen carrying capacity of the blood
3. Maintain blood's clotting ability (e.g. patients with bone marrow suppression)
4. Provide selected blood components as replacement therapy (e.g. clotting factors,
platelets)
Main components of blood (4) - ✔️✔️1. Plasma
2. Red Blood Cells
3. White Blood Cells
4. Platelets
, - Useful as a volume expander after acute blood loss
- Symptomatic anemia.
- Congestive heart failure
- When hemoglobin is less than 80 mmol/L
Platelets - Indications - ✔️✔️- Severe micro-vascular bleeding occurs e.g. DIC
(disseminated intravascular coagulation).
- For patients with platelet count of less than 10,000 to 20,000/mm3.
- Patients with platelet count of less than 50,000/mm3 who are bleeding.
Albumin - Indications - ✔️✔️- 5% solution used for volume expander, hypovolemic
shock & hypo-proteinemia.
- 25% solution used for severe burns and low albumin levels.
Cryoprecipitate - Indications - ✔️✔️- Obtained from FFP after slow thawing.
- Decreases microvascular bleeding during surgical procedures.
- Used as alternative to FFP, when factors needed but not volume.
- Given to increase fibrinogen level.
- For bleeding or immediately prior to an invasive procedure in patients with significant
hypofibrinogenemia.
Intravenous Immunoglobulins - Indications - ✔️✔️- IVIG is a protein replacement
therapy for patients which have decreased or abolished antibody production
capabilities.
- Administered to maintain adequate antibodies levels to prevent infections.
- Confers passive immunity.
- Immune deficiencies; inflammatory & autoimmune disease; acute infections.
- Autoimmune diseases: lupus, rheumatoid arthritis, MS - routine IG infusions
Autologus blood transfusion - ✔️✔️- Patient donates their own blood to be used later.
- Preoperative autologous blood.
- Intraoperative hemodilution.
- Intraoperative Blood salvage (Cell Saver).
- Postoperative Blood salvage.
Autologus - Hemodilution - ✔️✔️- Removal of one or more units of blood just before
surgery for transfusion to the patient during or at the end of the operation.
- Decreases the loss of red blood cells during surgery.
- After surgery, the patient's own blood is infused.
- The patient must be able to accommodate the anemia that the procedure causes.
Autotransfusion patients have difficulty with clotting because the autotransfusion
process removes several of the blood substances that support blood coagulation.
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