Blood Components
Dosage And Their
Administration
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





Bank plasma
Fresh frozen
Cryo supernate
Platelets



Packed cells
Red cells + additive
Plasma


Plasma +
Platelets
Platelet rich concentrate
Platelet rich plasma
Cryoprecipitate
Whole
blood
RBC
Buffy
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
M
e
m
Storage
-2–6OC
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
1
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 – Hypersplenism
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
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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
20
MD-3-49
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
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
24
Risk Benefit Analysis
benefit > risk
risk > benefit
Hb gm/dl 4 5 6 7 8 9 10 11 12 13 14
why not
transfuse
individual patient factors
decide transfusion trigger
why
transfuse
Time Limits for Infusion
Blood/
blood product
Whole blood/
red cells
Start infusion
Complete infusion
within 30 min. of within 4 hour
removing pack
(less in high
from
ambient temperature)
refrigerator
Platelet
concentrates
immediately
within 20 min
FFP
within 30 min
within 20 min
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RECORDING OF TRANSFUSION
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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