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Blood Components
Dosage And Their
Administration
DR ZIKRULLAH
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
Separation of blood components are desirable
because
1. Separation of blood components allows
optimal survival for each component
2. Allows transfusing specific blood components
according to the need of the patient
3. Allows use of unnecessary component which
may be contraindicated in a patient
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
Whole Blood
Processed within
8 hours )
Packed red blood cells Fresh frozen plasma Platelets
Component preparation
 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
Plasma +
Platelets
Buffy
RBC
Whole
blood
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
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 1M
e
m
Blood Components
2. Red cell concentrate ( packed red blood
cells )- whole blood without plasma. Hct
55 -75 % , Hb approximately 20 g /100
ml
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
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
PLATELETS
 Platelet units can be either
 Random donor units
 Apheresis units
 1 random donor unit contains 55 x109 platelets
 1 apheresis unit contains 240x109
Indications
 Production - Aplasia / Neoplasia
 Usage - TTP(thrombotic
thrombocytopenic purpura),
DIC(disseminated intravascular
coagulation)
 Destruction – immune
thrombocytopenic
purpura.Sequestration – Hyper-
splenism
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
Indications for platelet transfusion
 BLEEDING due to thrombocytopaenia
 Due to platelet dysfunction
 Prevention of spontaneous bleeding with counts
< 20,000
IMPORTANT PRECAUTIONS
 Stored at 20-24 Degree celcius.
 Constantly agitated
 Only last for 5 days
 Infused in 30 mins
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
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)
FRESH FROZEN PLASMA
Indication
 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
19
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 15 - 20 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-3-4920
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
Dosage & Administration for
FFP
Dosage - 10-15 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
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
Risk Benefit Analysis
benefit > risk risk > benefit
Hb gm/dl 4 5 6 7 8 9 10 11 12 13 14
why not
transfuse
why
transfuse
individual patient factors
decide transfusion trigger
26
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
Time Limits for Infusion
RECORDING OF TRANSFUSION
27
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

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Effective Blood Transfusion Using Components

  • 1. Blood Components Dosage And Their Administration DR ZIKRULLAH
  • 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 1. Separation of blood components allows optimal survival for each component 2. Allows transfusing specific blood components according to the need of the patient 3. 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
  • 5. Whole Blood Processed within 8 hours ) Packed red blood cells Fresh frozen plasma Platelets
  • 6. Component preparation  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 Plasma + Platelets Buffy RBC 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 1M e m
  • 9. Blood Components 2. Red cell concentrate ( packed red blood cells )- whole blood without plasma. Hct 55 -75 % , 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
  • 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
  • 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
  • 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 20-24 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. FRESH FROZEN PLASMA Indication  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 19
  • 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 15 - 20 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-3-4920
  • 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 - 10-15 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. 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 benefit > risk risk > benefit Hb gm/dl 4 5 6 7 8 9 10 11 12 13 14 why not transfuse why transfuse individual patient factors decide transfusion trigger
  • 26. 26 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 Time Limits for Infusion
  • 27. RECORDING OF TRANSFUSION 27 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