Transfusion of blood products

2016 ◽  
Author(s):  
Alison Smith
Keyword(s):  
Blood Transfusion ◽  
Carrying Capacity ◽  
Blood Cells ◽  
Fresh Frozen Plasma ◽  
Major Haemorrhage ◽  
Blood Products ◽  
Unlimited Supply ◽  
Fresh Frozen ◽  
Oxygen Carrying Capacity ◽  
Frozen Plasma

The transfusion of blood products may be required in the pre- and post-operative periods. However, there are inherent risks associated with blood transfusion, and there is not an unlimited supply of blood donations available. When a patient is anaemic, red blood cells should be transfused to maintain the oxygen-carrying capacity of blood. Blood products, such as platelets and fresh frozen plasma, are transfused to correct a coagulopathy and during major haemorrhage. This chapter reviews the physiology of blood, including ABO compatibility and rhesus status, the main blood products available for transfusion, and transfusion policy, including the treatment of major haemorrhage and the refusal of blood products.

Blood transfusion

2015 ◽  
Author(s):  
Drew Provan ◽  
Trevor Baglin ◽  
Inderjeet Dokal ◽  
Johannes de Vos
Keyword(s):  
Blood Transfusion ◽  
Red Blood Cells ◽  
Intravenous Immunoglobulin ◽  
Blood Cells ◽  
Platelet Transfusion ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Fresh Frozen ◽  
Religious Reasons ◽  
Frozen Plasma

Introduction - Using the blood transfusion laboratory - Transfusion of red blood cells - Platelet transfusion - Fresh frozen plasma - Intravenous immunoglobulin - Transfusion transmitted infections - Irradiated blood products - Strategies for reducing blood transfusion in surgery - Maximum surgical blood ordering schedule (MSBOS) - Patients refusing blood transfusion for religious reasons, i.e. Jehovah’s Witnesses

Blood transfusion

2018 ◽  
Author(s):  
Drew Provan ◽  
Trevor Baglin ◽  
Inderjeet Dokal ◽  
Johannes de Vos ◽  
Shubha Allard ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Red Blood Cells ◽  
Intravenous Immunoglobulin ◽  
Blood Cells ◽  
Platelet Transfusion ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Fresh Frozen ◽  
Religious Reasons ◽  
Frozen Plasma

Introduction - Using the blood transfusion laboratory - Transfusion of red blood cells - Platelet transfusion - Fresh frozen plasma - Intravenous immunoglobulin - Transfusion transmitted infections - Irradiated blood products - Strategies for reducing blood transfusion in surgery - Maximum surgical blood ordering schedule (MSBOS) - Patients refusing blood transfusion for religious reasons, i.e. Jehovah’s Witnesses

scholarly journals Clinical Results of a Massive Blood Transfusion Protocol for Postpartum Hemorrhage in a University Hospital in Japan: A Retrospective Study

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 983
Author(s):  
Daigo Ochiai ◽  
Yushi Abe ◽  
Rie Yamazaki ◽  
Tomoe Uemura ◽  
Ayako Toriumi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Blood Cells ◽  
Correlation Coefficients ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Fresh Frozen ◽  
Transfusion Protocol ◽  
Frozen Plasma

Background and objectives: Massive postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide. A massive transfusion protocol (MTP) may be used to provide significant benefits in the management of PPH; however, only a limited number of hospitals use MTP protocol to manage massive obstetric hemorrhages, especially in Japan. This study aimed to assess the clinical outcomes in patients in whom MTP was activated in our hospital. Materials and Methods: We retrospectively reviewed the etiology of PPH, transfusion outcomes, and laboratory findings among the patients treated with MTP after delivery in our hospital. Results: MTP was applied in 24 cases (0.7% of deliveries). Among them, MTP was activated within 2 h of delivery in 15 patients (62.5%). The median estimated blood loss was 5017 mL. Additional procedures to control bleeding were performed in 19 cases, including transarterial embolization (18 cases, 75%) and hysterectomy (1 case, 4.2%). The mean number of units of red blood cells, fresh frozen plasma, and platelets were 17.9, 20.2, and 20.4 units, respectively. The correlation coefficients of any two items among red blood cells, fresh frozen plasma, platelets, blood loss, and obstetrical disseminated intravascular coagulation score ranged from 0.757 to 0.892, indicating high levels of correlation coefficients. Although prothrombin time and activated partial thromboplastin time levels were significantly higher in the <150 mg/dL fibrinogen group than in the ≥150 mg/dL fibrinogen group at the onset of PPH, the amount of blood loss and blood transfusion were comparable between the two groups. Conclusions: Our MTP provides early access to blood products for patients experiencing severe PPH and could contribute to improving maternal outcomes after resuscitation in our hospital. Our study suggests the implementation of a hospital-specific MTP protocol to improve the supply and utilization of blood products to physicians managing major obstetric hemorrhage.

scholarly journals DIFFERENCES IN CHANGES OF HEMOGLOBIN BETWEEN 6-12 HOURS AND 12-14 HOURS AFTER TRANSFUSION

2018 ◽  
Vol 24 (2) ◽  
pp. 108
Author(s):  
Rosita Linda ◽  
Devita Ninda
Keyword(s):  
Blood Transfusion ◽  
Secondary Data ◽  
Hemoglobin Concentration ◽  
Fresh Frozen Plasma ◽  
Blood Components ◽  
Blood Products ◽  
Fresh Frozen ◽  
Frozen Plasma ◽  
Hemoglobin Measurement ◽  
Baseline Hemoglobin

Each year more than 41,000 blood donations are needed every day and 30 million blood components are transfused. Blood products that can be transfused include Packed Red Cells (PRC), Whole Blood (WB), Thrombocyte Concentrate (TC), Fresh Frozen Plasma (FFP). Monitoring Hemoglobin (Hb) after transfusion is essential for assessing the success of a transfusion. The time factor after transfusion for Hemoglobin (Hb) examination needs to be established, analyze to judge the success of a blood transfusion which is performed. The aim of this study was to analyze the differences in changes of hemoglobin between 6-12 hours, and 12-24 hours after-transfusion. This study was retrospective observational using secondary data. The subjects were patients who received PRC, and WBC transfusion. At 6-12, and 12-24 hours after-transfusion, hemoglobin, RBC, and hematocrit were measured. Then the data were analyzed by unpaired t-test. The collected data included the results of the Hb pre-transfusion, 6-12, and 12-24 hours after-transfusion. The subjects of this study were 98 people. The administration of transfusion increased by 10-30% in hemoglobin concentration at 6-12 hours after-transfusion. While at 12-24 hours after-transfusion, hemoglobin after-transfusion increased 15-37% from the baseline. Hemoglobin values were not different at any of the defined after-transfusion times (p = 0.76 (p>0.05)). Hemoglobin values were not different at 6-12 hours, and 12-24 hours after-transfusion.    Keywords: Hemoglobin, measurement, after-transfusion 

BLOOD PRODUCTS TRANSFUSION DURING 2012-13 IN PESHAWAR, PAKISTAN

2019 ◽  
Vol 16 (4) ◽  
pp. 105-108
Author(s):  
Rashid Azeem ◽  
Nadia Altaf ◽  
Syed Humayun Shah ◽  
Naeem Khattack ◽  
Muhammad Tariq Masood Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Red Blood Cells ◽  
Whole Blood ◽  
Blood Cells ◽  
Fresh Frozen Plasma ◽  
Health Care Facilities ◽  
Blood Products ◽  
Packed Red Blood Cells ◽  
Fresh Frozen ◽  
Frozen Plasma

Background: Blood products transfusion has been a major treatment modality especially in critical care settings. The objectives of this study were to determine frequency and distribution of blood products transfusion in public and private health care facilities during 2012-2013 in Peshawar, Pakistan. Materials & Methods: This cross-sectional, study was conducted in the Department of Pathology, Northwest School of Medicine, Peshawar, Pakistan from 1st January 2012 to 31st December 2013. Sample size was 2,04,942 blood products transfusion, selected through consecutive non probability technique. All allogeneic cases of transfusions in inpatient and emergency were included. A total of six public, one private and two stand-alone blood banks were enrolled into the study. Demographic variable were name of the health care facility, sex and age groups of donors. Research variables were type of blood products transfusion (whole blood, packed red blood cell, fresh frozen plasma, platelets). All variables being categorical were described as count and percentages. Data was analyzed using software SPSS version 23. Results: Out of 2,04,942 units, 1,33,212 (65%) were men and 71,730 (35%) women. Packed red blood cells were the most commonly used component with 80227 units (39.1%), whole blood 77655 units (37.8%), Fresh frozen plasma 35932 units (17.5%) and platelets 11128 units (5.6%). Blood products transfusion was 46927 units (22.89%) in 65 years. Conclusion: Modal group was men. Packed red blood cells were the most frequently transfused blood component in hospitals of Peshawar especially Lady reading hospital. Most common age group was 18-40 years. Whole blood still comprises a significant fraction of transfusions which is alarming.

Transfusion Requirements and Blood Bank Support in Heart and Lung Transplantation

2020 ◽  
Vol 52 (1) ◽  
pp. 74-79
Author(s):  
Dong-Won Yoo ◽  
Hyun-Ji Lee ◽  
Seung-Hwan Oh ◽  
In Suk Kim ◽  
Hyung-Hoi Kim ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Fresh Frozen Plasma ◽  
Blood Component ◽  
Blood Products ◽  
Transfusion Requirements ◽  
Blood Banks ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Objective Transplantations may require massive transfusion of blood products. Therefore, blood banks need to predict, prepare, and supply the required amount of blood products. Methods We measured the volume of transfused blood components as red blood cells, fresh frozen plasma, platelets, and cryoprecipitate in 54 and 89 patients who received heart and lung transplantation, respectively, in our hospital between January 2012 and December 2019. Results Platelets were the most frequently transfused blood component. Transfusion volumes during heart and lung transplantation surgeries differed: red blood cells, 7.83 units vs 14.84 units; fresh frozen plasma, 2.67 units vs 12.29 units; platelets, 13.13 units vs 23.63 units; and cryoprecipitate, 1.74 units vs 2.57 units; respectively. The average transfusion volume of transplants was different each year. Conclusion Periodic evaluation of transfusion requirements will facilitate the efficient management of blood products at the time of transplantation and help blood banks predict changes in blood requirements.

scholarly journals Use of Blood Components in Major Obstetric Hemorrhage: Preliminary Findings from the Australian and New Zealand Massive Transfusion Registry (ANZ-MTR)

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1563-1563 ◽  
Author(s):  
Naomi J Aoki ◽  
Kylie Venardos ◽  
Nick Andrianopoulos ◽  
Zoe K Mcquilten ◽  
Amanda J Zatta ◽  
...  
Keyword(s):  
Blood Cells ◽  
Massive Transfusion ◽  
Fibrinogen Level ◽  
Fresh Frozen Plasma ◽  
Blood Components ◽  
Blood Products ◽  
Obstetric Hemorrhage ◽  
Laboratory Results ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Introduction: Major obstetric hemorrhage (MOH) can develop rapidly and, due to the unique characteristics of maternity patients, early recognition and management can be challenging. Use of blood components in MOH can be life-saving however there is uncertainty about optimal use of these products and the role of adjunctive therapies. The ANZ-MTR generates observational data on current transfusion management and outcomes in critically bleeding patients receiving massive transfusion (MT) across all clinical settings. This study aimed to describe the transfusion strategies used in the MOH population and report their outcomes. Methods: Patients who had a MOH and received a MT (≥5 units of red blood cells [RBC] in 4h) between April 2011 and December 2013 at 15 Australian & NZ hospitals were identified. Data on the type and volume of blood products transfused as well as selected laboratory results and clinical outcomes were reviewed. Results: A total of 154 cases were identified and reviewed, representing 6% of the total ANZ-MTR cohort. Median age was 34 [IQR29-37] years and 99% of women had a Charlson Comorbidity Index score ≤ 1. Table 1 presents the blood products transfused. The median [IQR] fresh frozen plasma (FFP) to RBC ratio and platelets to RBC ratio was 0.6 [0.3-0.8] and 0.1 [0-0.2], respectively. FFP, platelets and cryoprecipitate were transfused in 87%, 66% and 49% of patients. Prothrombinex-HT was administered to 1 patient and 3 patients received rFVIIa. Table 2 presents the laboratory results taken prior to MT onset as well as the lowest and highest result reported within 24hours after the MT onset. Fibrinogen levels following MT onset was available for 121 (79%) patients. Of these, 46% women had a fibrinogen level <2 g/L of which 34% did not receive cryoprecipitate. Mean [SD] hemoglobin level 24h post-MT onset was 108g/L [19]. Regarding patient outcomes, median [IQR] hospital length of stay was 8 [4-43] days, 59 (38%) women were admitted to ICU, 40 (26%) underwent a subtotal or total hysterectomy and 3 (1.9%) died in-hospital. Table 1. Number of patients and median number of units transfused 24h post-MT onset (n = 154). Blood product n (%) Median units (IQR) Red blood cells 154 (100) 7 [6-10] Fresh frozen plasma 134 (87) 4 [2-6] Platelets 102 (66.2) 1 [0-1] Cryoprecipitate 76 (49.4) 0 [0-5] Table 2. Laboratory values* reported Value prior to MT onset Lowest value 0-24h post-MT onset Highest value 0-24h post-MT onset Hemoglobin (g/L) 102 [81-120], 84 77 [67-90]; 92 108 [95-119]; 92 INR 1.1 [0.9-1.2]; 33 1.1 [.9-1.2]; 72 1.3 [1.1-1.4]; 72 aPPT(s) 31 [28-35]; 39 31 [29-34]; 88 37 [33-46]; 88 Fibrinogen level (g/L) 3.2 [1.6-3.9]; 25 1.9 [1.4-2.6]; 79 2.9 [2.5-3.5]; 79 Platelet Count (109/L) 210 [158-249];84 102 [74-135]; 92 146 [110-190]; 92 pH 7.3 [7.3-7.4]; 22 7.3 [7.2-7.3]; 70 7.4 [7.4-7.5]; 70 *Data are Median [IQR]; % patients with laboratory test available Conclusion: Women with MOH requiring massive transfusion were generally healthier and younger than patients of other clinical contexts in the ANZ-MTR. Although there were few in-hospital deaths reported (1.9%), a large proportion of the cohort required a hysterectomy during their hospital admission. Further information on transfusion practice, including understanding optimal blood component ratios, is required to inform clinical practice and minimize risk in the obstetric setting. Disclosures McLintock: Novo Nordisk Australasia: Honoraria.

scholarly journals Management of Massive Blood Transfusion-a case study

Pulse ◽  
2014 ◽  
Vol 5 (1) ◽  
pp. 39-43
Author(s):  
Sufia Khatun Lima ◽  
Monowara Begum ◽  
Anil Kumar Gupta ◽  
Lutful Aziz ◽  
SP Mitra
Keyword(s):  
Blood Transfusion ◽  
Multidisciplinary Approach ◽  
Fresh Frozen Plasma ◽  
General Surgeon ◽  
Blood Products ◽  
Massive Blood Transfusion ◽  
Fresh Frozen ◽  
Transfusion Protocol ◽  
Frozen Plasma

Management of a complicated obstetric patient with profuse bleeding following caesarean section (under GA) required massive blood transfusion was managed properly with multidisciplinary approach in ICU. The involvement of obstetrician, anesthesiologist, intensivist, general surgeon, hematologist & gastroenterologist as a team in a single setup is essential for the management of such patients and the best outcome. The patient received total 117 units of blood products among which 20 units whole blood, 17 units packed red blood cell, 40 units of fresh frozen plasma and 40 units of platelet concentrate. Despite this massive blood transfusion, the patient recovered fully with minimal complications as we follow the near standard blood transfusion protocol. DOI: http://dx.doi.org/10.3329/pulse.v5i1.20189 Pulse Vol.5 January 2011 p.39-43

scholarly journals Correction of Postoperative Anemia in Patients undergoing Mitral Valve Replacement through Blood Saving Technology

2020 ◽  
pp. 55-60
Author(s):  
B. M. Gumeniuk
Keyword(s):  
Blood Transfusion ◽  
Blood Cells ◽  
Fold Increase ◽  
Fresh Frozen Plasma ◽  
Packed Red Blood Cells ◽  
Fresh Frozen ◽  
Group A ◽  
Group B ◽  
Donated Blood ◽  
Frozen Plasma

The aim. To investigate anemia of chronic disease (ACD) in patients with mitral valvular disease, to provide preoperative correction in these patients and to determine the level of postoperative anemia after mitral valve replacement (MVR) through blood saving technology (BST) under artificial circulation (AC).Materials and methods. This is a study of 104 patients operated due to acquired mitral heart defects under AC. According to the baseline Hb, Ht, serum iron (SI) as well as the use of BST during MVR, all the patients were divided into 3 groups. Group A included 47 patients with normal Hb concentration, Ht and SI, who underwent the surgical intervention without BST with blood transfusion. Group B included 35 patients without ACD who were operated without blood transfusion with the use of BST. The group C included 22 patients with preoperative ACD with low Hb, Ht, and SI. A week before surgery the patients of group C underwent preoperative correction of SI and erythropoiesis stimulation using erythropoietin. The patients of group C were operated using BST. Preoperative correction of anemia and the use of blood and BST during surgery in groups A, B, C were compared. The effect of preoperative ACD correction and erythropoiesis stimulation on the level of postoperative anemia in patients operated due to mitral heart disease through BST in group C and with or without correction in group B was studied.Results. The presented research results show that in group A, in order to sufficiently stabilize the level of Hb and Ht during the operation, donated blood components (590.0 ± 83.0 ml of packed red blood cells and 563.0 ± 68.0 ml of fresh frozen plasma) were used. The use of BST in the group B reduced the level of Hb by 17.4%, Ht by 15.8%, thrombocyties by 20.5%, and the intervention could be performed without donated blood transfusion. Preoperative correction of SI and administration of erythropoietin in patients with ACD resulted in 8.6-fold increase in SI, 5.5-fold increase in ferritin and increase in Hb by 8.1% before the intervention. The use of BST and hematopoietic technology during MVR in patients of group C stabilized SI, Hb and platelets in the operative period, which facilitates operations under AC without transfusion of donated blood components.Conclusions.1. In patients of group A, donor blood components (590.0 ± 83.0 ml of packed red blood cells and 563.0 ± 68.0 ml of fresh frozen plasma) were used to stabilize Hb and Ht during MVR without the use of BST.2. ACD correction in patients of group C with mitral heart disease has led to a 8.6-fold increase in SI (p˂0.05), increase in transferrin saturation coefficient by 36.8% (p˂0.05), and 5.5-fold increase in ferritin activity (p˂0.05).3. The use of BST in patients of group B undergoing MVR reduces the level of Hb by 17.4% (* p˂0.05) and platelets by 20.5% (* p˂0.05).4. Preoperative correction of SI with iron (III) hydroxide and hemapoiesis stimulation by erythropoietin in patients of group C with MVR using BST reduces anemia by 10.7% and thrombocytopenia by 5%.

scholarly journals First-line Therapy with Coagulation Factor Concentrates Combined with Point-of-Care Coagulation Testing Is Associated with Decreased Allogeneic Blood Transfusion in Cardiovascular Surgery

2011 ◽  
Vol 115 (6) ◽  
pp. 1179-1191 ◽  
Author(s):  
Klaus Görlinger ◽  
Daniel Dirkmann ◽  
Alexander A. Hanke ◽  
Markus Kamler ◽  
Eva Kottenberg ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Point Of Care ◽  
Coagulation Factor ◽  
Fresh Frozen Plasma ◽  
Packed Red Blood Cells ◽  
Fresh Frozen ◽  
Coagulation Factor Concentrates ◽  
Frozen Plasma

Introduction Blood transfusion is associated with increased morbidity and mortality. We developed and implemented an algorithm for coagulation management in cardiovascular surgery based on first-line administration of coagulation factor concentrates combined with point-of-care thromboelastometry/impedance aggregometry. Methods In a retrospective cohort study including 3,865 patients, we analyzed the incidence of intraoperative allogeneic blood transfusions (primary endpoints) before and after algorithm implementation. Results Following algorithm implementation, the incidence of any allogeneic blood transfusion (52.5 vs. 42.2%; P &lt; 0.0001), packed red blood cells (49.7 vs. 40.4%; P &lt; 0.0001), and fresh frozen plasma (19.4 vs. 1.1%; P &lt; 0.0001) decreased, whereas platelet transfusion increased (10.1 vs. 13.0%; P = 0.0041). Yearly transfusion of packed red blood cells (3,276 vs. 2,959 units; P &lt; 0.0001) and fresh frozen plasma (1986 vs. 102 units; P &lt; 0.0001) decreased, as did the median number of packed red blood cells and fresh frozen plasma per patient. The incidence of fibrinogen concentrate (3.73 vs. 10.01%; P &lt; 0.0001) and prothrombin complex concentrate administration (4.42 vs. 8.9%; P &lt; 0.0001) increased, as did their amount administered per year (179 vs. 702 g; P = 0.0008 and 162 × 10³ U vs. 388 × 10³ U; P = 0.0184, respectively). Despite a switch from aprotinin to tranexamic acid, an increase in use of dual antiplatelet therapy (2.7 vs. 13.7%; P &lt; 0.0001), patients' age, proportion of females, emergency cases, and more complex surgery, the incidence of massive transfusion [(≥10 units packed red blood cells), (2.5 vs. 1.26%; P = 0.0057)] and unplanned reexploration (4.19 vs. 2.24%; P = 0.0007) decreased. Composite thrombotic/thromboembolic events (3.19 vs. 1.77%; P = 0.0115) decreased, but in-hospital mortality did not change (5.24 vs. 5.22%; P = 0.98). Conclusions First-line administration of coagulation factor concentrates combined with point-of-care testing was associated with decreased incidence of blood transfusion and thrombotic/thromboembolic events.

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