1. Blood Components Dosage And Their Administration

2. Effective blood transfusion therapy depends on availability of different blood components
Components used separately or in combination can meet most patients transfusion needs and keep the risk of transfusion to minimum

3. Separation of blood components are desirable because
Separation of blood components allows optimal survival for each component
Allows transfusing specific blood components according to the need of the patient
Allows use of unnecessary component which may be contraindicated in a patient

4. 4. Several patients can be treated from one unit of donated blood
5. Use of blood components supplements blood supply and adds to the blood inventory

6. Component preparation
Plasma + Platelets
Buffy
RBC
Principle - Differential centrifugation
Red cells
Packed cells
Red cells + additive
Plasma
Bank plasma
Fresh frozen
Cryo supernate
Platelets
Platelet rich concentrate
Platelet rich plasma
Cryoprecipitate
Whole blood

7. DEFINITIONS
BLOOD PRODUCT = Any therapeutic substance prepared from human blood
WHOLE BLOOD = Unseparated blood collected into an approved container containing an anticoagulant preservative solution
BLOOD COMPONENT = 1. A constituent of blood , separated from whole blood such as
Red cell concentrate
Plasma
Platelet concentrates
2. Plasma or platelets collected by apheresis
3. Cryoprecipitate prepared from fresh frozen plasma

8. Blood Components THE PRBC Storage - 2 – 6 O C Unit of issue
- 1 donation ( unit or pack )
Administration
- ABO & Rh compatible
- Never add medication to a unit
- Complete transfusion within 4 hrs of commencement
Member 1

9. Blood Components
2. Red cell concentrate ( packed red blood cells )- whole blood without plasma. Hct % , Hb approximately 20 g /100 ml

10. Indications
Trauma - Acute blood loss with > 20% loss of blood volume
Surgery - Trigger – 10gm% - 8gm% Rate of development of anemia, General condition and type of surger
Radiotherapy

11. Dosage & Administration
Dosage - 1 unit/10 kg body wt
Adult dose is 4-8 units
Administration - Preferably ABO & Rh group specific but not essential
Other groups can be used 11

12. PLATELETS Platelet units can be either
Random donor units
Apheresis units
1 random donor unit contains 55 x109 platelets
1 apheresis unit contains 240x109

13. Indications Production - Aplasia / Neoplasia
Usage - TTP(thrombotic thrombocytopenic purpura), DIC(disseminated intravascular coagulation)
Destruction – immune thrombocytopenic purpura.Sequestration – Hyper- splenism 13

14. Guidelines for Platelet Tx.
Mild - 50,000-1,00,000/µl
Tx - usually not required
Moderate - 20,000-50,000/µl
Tx-if symptomatic or has to undergo surgery/trauma
Severe - < 20,000/µl
Risk of bleeding - high
Prophylactic Tx 14

15. Indications for platelet transfusion
BLEEDING due to thrombocytopaenia
Due to platelet dysfunction
Prevention of spontaneous bleeding with counts < 20,000

16. IMPORTANT PRECAUTIONS
Stored at Degree celcius.
Constantly agitated
Only last for 5 days
Infused in 30 mins

17. Fresh Frozen plasma
Fresh frozen plasma – labile & nonlabile clotting factors, albumin and immunoglobulin. Factor VIII ( 8 ) level at least 70 % of normal fresh plasma level
Storage
- 20 C for 1 yr, - 65 C for 7 yrs.
Before use thawed at 37 o C

18. Fresh frozen plasma
Indications
- Replacement of multiple coagulation factor deficiencies eg
Liver disease
Anticoagulant overdose
Depletion of coagulation factors in pts receiving large volume transfusions
DIC (disseminated intravascular coagulation)

19. Indication FRESH FROZEN PLASMA factor deficiencies :- Contraindication
Clinically significant deficiency of Factors II, V, X, XI
Replacement of multiple coagulation
factor deficiencies :-
liver disease , warfarin treatment,
dilutional and consumption coagulopathy
Contraindication
Volume expansion
Immunoglobulin replacement
Nutritional support
Wound healing

20. FRESH FROZEN PLASMA Precaution
Acute allergic reaction are common
Anaphylactic reaction may occur
Hypovolemia alone is not an indication for
use
Dosage - Initial dose of ml / kg
Administration
Must be ABO compatible, Rh not required
Infuse as soon as possible after thawing
( within 6 hrs )
using standard blood administration set
30/11/49
MD-3-49

21. FFP Fresh Frozen Plasma
Plasma collected from single donor units or by apheresis
Frozen within 8 hours of collection
-40o C
Can last for a year

22. Dosage & Administration for FFP
Dosage ml/Kg(Approx 2-3 bags for an adult)
Administration - Thawed at +37o C before transfusion
ABO compatible
Group AB plasma can be used for all patient

23. Do`s and Dont`s In Blood and Blood Components

24. DO`S
Complete the blood request form
Order blood in advance, if possible
Provide clear information on blood products being requested, number of units requested, reason for transfusion, urgency

25. Risk Benefit Analysis risk > benefit benefit > risk why not
Hb gm/dl
why not
transfuse
why
transfuse
individual patient factors
decide transfusion trigger

26. Time Limits for Infusion
Blood/ Start infusion Complete infusion
blood product
Whole blood/ within 30 min. of within 4 hour
red cells removing pack (less in high
from ambient temperature)
refrigerator
Platelet immediately within 20 min
concentrates
FFP within 30 min within 20 min

27. RECORDING OF TRANSFUSION
Consent from patient and/or relatives
Reason for transfusion
Signature of the prescribing clinician
Pre-transfusion checks of :
patient’s identity, blood pack, compatibility label
signature of the person performing the check
Transfusion
type and volume of component, donation number,
blood group, time at which transfusion commenced,
signature of person administering the transfusion
Any transfusion reaction
Return the transfusion slip to the blood bank