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

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)

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

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

 

 Downloadable Blood Transfusion Guidelines