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🌱 來自：transfusion therapy

Blood Products and Indications

• Packed red blood cells (PRBCs)
  • For acute blood loss or to ↑ O2-carrying capacity if end organ ischemia. 1 U PRBC → ↑ Hb by ~1 g/dL. Hb goal >7 g/dL adequate for UGIB & critically ill (NEJM 2013;368:11 & 2014;371:1381), ≥8 in acute MI and peri-cardiac surgery (NEJM 2018;379;1224; JAMA 2021;325:552).
• Platelets transfusion (plts) (Annals Int Med 2015;162:205)
• Fresh frozen plasma (FFP)
  • Contains all coagulation factors.
  • For bleeding due to defic. of multiple coag factors (eg, DIC, TTP/HUS, liver disease, dilution).
  • Nb, reverse warfarin w/ Kcentra = 4 factor PCC (JACC 2020;76:594).
• Cryoprecipitate
  • Enriched for fibrinogen, vWF, VIII, and XIII.
  • 1st line for fibrinogen <100 mg/dL.
  • For bleeding in vWD factor XIII deficiency, use if other products not available.

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• Irradiated
  • Prevents donor T-cell engraftment and risk of transfusion-assoc. GVHD (HSCT, heme malignancy, congenital immunodeficiency).
• CMV-negative
  • From CMV-negative donors. For CMV-seronegative pregnant women, transplant candidates/recipients, SCID, AIDS Pts.
• Leuko- reduced
  • WBCs cause HLA alloimmunization & fever (cytokines) and carry CMV. For chronically transfused Pts, potential Tx recip., h/o febrile nonhemolytic transfusion rxn, cases in which CMV-neg products desired but unavailable.
• IV immune globulin (IVIg)
  • Polyvalent IgG from >1000 donors. For postexposure prophylaxis (eg, HAV), certain autoimmune disorders (eg, ITP, Guillain-Barré, MG, CIDP), congenital or acquired hypogammaglobulinemia (CVID, CLL).
• Therapeutic apheresis
  • Removes plasma large molec wt subst. (eg, cryoglobulinemia, Goodpasture’s, Guillain-Barré, hyperviscosity syndrome), or cells (eg, leukemia w/ hyperleukocytosis, sx thrombocytosis) from plasma. TTP: replace ADAMTS13. RBC exchange for SCD acute chest or stroke.
• Massive transfusion