Platelet Concentrates
Cryoprecipitate
• Indicatons:
Blood Products
Indicates for disorders associated with a deficiency of factors VII (von willebrand’s dz)
(a) Used to correct or prevent hemorrhage when a patient has a patient has a platelet dysfunction
(b) To treat thrombocytopemia
(c) To treat acute leukemia and marrow aplasia
Contain a high concentration of platelets suspended in a small quantity of plasma separated from WB within 6 hrs post-donation before refrigeration
Adult dosage: 10 units (with repeated transfusion every 8-12 hrs until the deficiency is corrected)
Infuse at 5-10 mL/min
o The cold insoluble portion of plasma remaining after FFP has been thawed.
o Consists of clotting factors suspended in plasma
• Nursing considerations:
Pooled platelet concentrates are made by extracting platelets from 4 to 6 units WB
o One unit contains:
-250 units fibrinogen
-80 to 120 units of factor VII, and
-20-30% of factor XII found in a unit of WB
-infused within 3 to 5 minutes
(a) ABO compatibility isn’t necessary but is preferable with repeated platelet transfusion, RH type march is preferred
(b) Administer at 150 to 200 mL/hr, or as rapidly as the patient can tolerate, don’t exceed 4 hrs
(c) Avoid administering platelets when the patient has a fever
• Most common complications:
WHOLE BLOOD
Modified Blood Products
• Don’t refrigerate & don’t use micro-aggregate filters
CIRCULATORY OVERLOAD
Signs & symptoms:
Dyspnea
Coughing
Rising venous pressure
Distended neck veins and
Crackles in the bases of the lungs.
• One unit: 50-70 mL (itrmc)
-Unprocessed blood containing all cellular and plasma components of donor blood
-consists of plasma, plasma proteins, red blood cells & an anticoagulant
Most common complications:
- Febrile transfusion reactions and allergic transfusion reaction
-Subsequently divided into components parts: PRBCs, platelet concentrates, FFPs, and cryoprecipitate
-One (1) unit: 500 mL
Are blood preparations that undergo further processing, such as a additional washing, filtration, irradiation and freezing to reduce the risk of transfusion reactions
Washed RBCs (PNSS)
-indicated for patients who had febrile, non-hemolytic TFN reactions
Particularly useful to immunocompromised patients
Rate of administration:
-for adults: infuse 100 ml over 15 minutes
The average dose is typically 1 unit of platelets for every 10 kg of body weight
• Nursing considerations:
• Administration set use:
-infused within 4 hrs after the unit has left the blood bank & its proper refrigeration
-avoid giving when the patient can’t tolerate the circulating volume.
• Indications:
-a small pore filter, 20 to 40 µm (as blood warmer) to prevent cardiac arrhythmias and hypothermia complications
-used to replace blood after a large loss (greater the 1000 mL) in cases of hemorrhage, trauma &burn.
National Blood Service Act of 1994
Fresh frozen Plasma
Packed Red Blood Cells
• Most common complications:
• Nursing considerations:
• Who can donate blood?
• What are the reasons why a person cannot donate blood?*
(b) Large volume transfusion of FFP may require correction for hypocalcemia
The dosage of plasma depends on the person’s clinical status, including the Prothrombin time (PT) and Partial thromboplastin time (PTT)
• Temporary conditions:
-be at least age 18*
-weight: at least 110 lbs. (50 kg)*
Blood volume collected will depend mainly on your body weight
-pulse rate: between 90 & 100 beats/min with regular rhythm*
-blood pressure: between 90 & 160 systolic and 60 & 100 diastolic*
-hemoglobin: at least 125 g/L (12.5 d/dL)*
-not have donated in the past 56 days
*Philippines blood center (source)
Hemolytic transfusion reactions, ferbile transfusion reactions and allergic transfusion reactions
- Produced by removing plasma from a unit of whole blood by centrifugation using a closed sterile system
Consists of plasma & platelets
One unit: 400 mL- has 50 to 400 mL of plasma and a min. of 5.5 platelets (approx.)
(a) Cross- matching ABO compatibility isn’t necessary but is preferable with repeated plasma transfusion; Rh type match is preferred
-there are certain conditions that prevent a person from donating blood temporarily or permanently.
Pregnancy
Acute fever
Recent alcohol intake
Ear or body piercing and tattooing
Recent surgery
Comprised of essential clothing factors, plasma proteins, water and carbohydrates
One unit: from 200 to 250 mL; infused at 10-15 ml/kg per dose
• Indications:
• Administration set use:
• Nursing considerations:
(a) To expand plasma volume
(b) To treat pot-surgical hemorrhage or shock
(c) To correct an undetermined coagulation factor deficiency
Micro-aggregate filters
(micropore filter transfusion medicine a 2nd- generation blood filter with a pore size of 20-4- µm which removes 75-90& of WBCs, used to transfuse packed RBCs)
• Persons with the following conditions are not allowed to donate blood anytime:
• Known as republic act 7719
• An act promoting VOLUNTARY BLOOD DONATION
• Providing for an adequate supply of safe blood, regulating blood banks and providing penalties for violation
Indications:
-infused within 4 hrs after the unit has left the blood bank & its proper refrigeration
-RBCs have the same oxygen-carrying capacity as whole blood, minimizing the hazard of volume overload
• How often can a person donate blood?*
Cancer
Cardiac disease
Severe lung dz
Hepatitis B & hepatitis C
HIV infection, AIDS or sexually transmitted disease
High risk occupation (e.g prostitution)
Unexplained weight loss of more than 5 kg over 6 months
Chronic alcoholism
(a) To restore and/or maintain adequate oxygenation without the risks associated with a greater extension of blood volume
(b) To correct anemia and surgical blood loss
(d) A clotting disorder (such as one resulting from liver failure or another hepatic disorder) *anticoagulation problems subsequent to warfarin (coumadin) therapy
• Rate of administration:
The minimum interval between 2 donations is 12 weeks (3 months). This interval allows our body to restore its iron stock.
Dosage: infused within 15 to 30 minutes (general guide)
Can be stored as a liquid or frozen within 6 hrs after collection (or post donation) and rapidly frozen to -30˚C for storage
(e) Acquired or congenital clotting factor disorders (hemophilia)
-for adult: 1 unit over 1 ½ to 2 hrs
-for children: 2-5 mL/kg over an hour