Transfusing Flashcards
What flow rate is recommended for RBCs?
Start at 1-2mL/min (60-120mL/hr), then increase as tolerated up to about 4mL/min (240mL/hr).
What flow rate is recommended for platelets?
Start at 2-5mL/min (120-300mL/hr), then increase as tolerated up to 5mL/min (300mL/hr)
What flow rate is recommended for plasma?
Start at 2-5mL/min (120-300mL/hr), then increase as tolerated up to 5mL/min (300mL/hr)
What flow rate is recommended for granulocytes?
Start at 1-2mL/min (60-120mL/hr), then increase as tolerated up to about 2-2.5mL/min (120-150mL/hr).
What flow rate is recommended for cryoprecipitated AHF?
As rapidly as tolerated
How should transfusion be approached in patients with severe cardiopulmonary or renal disease?
Slow the rate of transfusion.
What is the role of antipyretics as premedication in transfusion?
It is controversial; it may mask febrile reactions (not really; reduces magnitude) but will ease the transfusion.
When should blood warmers be used?
During large-volume transfusions (where hypothermia may become a real consideration) and for neonates.
What is the benefit of the macroaggregate filter in most tubing?
Removes large debris (170-260um) such as fibrin strands.
What is the role of bedside leukoreduction?
Limited; this is finicky and affected by gravity, and is associated with hypothermic transfusion reactions when patients are on ace-inhibitors.
What fluids are compatible for priming lines for RBC transfusion?
Only 0.9% NS; D5W bursts red cells and LR contains calcium which counteracts citrate.
What conditions are required for out-of-hospital transfusion to be permissible?
A skilled professional must be present and able to both monitor the patient and call for help. The patient must have no history of severe transfusion reactions.
How much should platelet count rise with apheresis platelets? When should post-counts be obtained?
30-60k.
Obtain 10-60min after transfusion (if already gone»_space; favor immune refractoriness)
