Red Blood Cells
If transfusing Red Blood Cells one of the following should be present:
- Hgb ≤ 7 g/dl / Hct < 21%
- Hgb ≤ 8 g/dl / Hct < 24% in post-operative surgical patients or cardiac or cerebrovascular disease
- Rapid or ongoing blood loss
- Patient with anemia and evidence to support the need for increased oxygen carrying capacity (e.g. chest pain, tachycardia or orthostatic hypotension
unresponsive to fluid resuscitation, or congestive heart failure)
- Perioperative Hgb<9 g/dl / Hct<27% and operative procedure or clinical situation associated with major, predictable blood loss
- Outpatients chronically transfused
- Anemia and acute coronary syndrome
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Platelets
If transfusing Platelets one of the following should be present (Apheresis, Leukoreduced):
Note: A single unit of apheresis platelets will usually increase the platelet count by 25-35,000/
- Platelet count ≤10,000/μL: prophylactic in a patient with failure of platelet production
- Platelets <15-20,000/μL in patients with hematologic malignancy or on active chemotherapy
- Platelet count ≤50,000/μL: with active bleeding on an invasive procedure (either recent, in-progress or planned)
- Platelet count ≤100,000/μL: undergoing a neurosurgical procedure or with intracranial or ocular hemorrhage
- Platelet dysfunction (inherited or acquired)
- Class IV shock/low platelet count secondary to massive transfusion (consider concurrent FFP transfusion)
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Fresh Frozen Plasma
If transfusing Fresh Frozen Plasma one of the following should be present:
Note: Dose depends on the clinical situation and underlying disease process. When given for coagulation factor replacement a dose of 10-20 mL/kg is usually
adequate; avg 3-6 units of FFP.
- Preoperative or bleeding pt with INR > 1.5 or significantly elevated PTT
- Emergent reversal of warfarin anticoagulation
- Active DIC
- Massive transfusion or large volume crystalloid infusion (for or to prevent dilutional coagulopathy)
- Other
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Cryoprecipitate
If transfusing Cryoprecipitate one of the following should be present:
Note: Pooled into bags of 5 units
- Fibrinogen ≤150 mg/dL + hemorrhage
- Fibrinogen < 80-100 mg/dl
- Dysfibrinogenemia
- Active DIC
- Uremic platelet dysfunction
- Massive transfusion Other
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