What are the different types of blood products?
These include red blood cells, plasma, platelets, albumin, or cryoprecipitate. This is what you think of when talking about "blood." A unit of PRBCs is red blood cells centrifuged out from whole blood. The hematocrit of PRBCs is approximately 55%. This type of blood product is often given in the case of acute bleeding.
What kind of blood is used for blood transfusion?
Whole blood: Whole blood is typically reserved for only cases of severe hemorrhage. Whole blood contains clotting factors, red blood cells, white blood cells, plasma, platelets, and plasma proteins. Some blood transfusion reactions and blood transfusion errors occur as the result of inaccurate client identification.
How is blood component loss managed during massive blood loss?
Blood component loss during massive blood loss is best managed by following the massive transfusion protocol (MTP). Mild to moderate blood loss can be managed with crystalloid or colloid infusions alone. However, with increasing loss, dilutional anaemia and later dilutional coagulopathy sets in.
What are the treatment options for acute blood loss?
Treatment of acute blood loss. . Practice guidelines for perioperative blood transfusion and adjuvant therapies: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Damage control resuscitation: directly addressing the early coagulopathy of trauma.
How do you treat massive blood loss?
Blood component loss during massive blood loss is best managed by following the massive transfusion protocol (MTP). Mild to moderate blood loss can be managed with crystalloid or colloid infusions alone. However, with increasing loss, dilutional anaemia and later dilutional coagulopathy sets in.
What blood product is used to stop bleeding?
Platelets are small, sticky cells that make plugs on walls of your blood vessels (veins and arteries). This helps to prevent or stop bleeding.
What blood type is best administered in emergency cases?
blood group type O negative bloodFor emergency transfusions, blood group type O negative blood is the variety of blood that has the lowest risk of causing serious reactions for most people who receive it. Because of this, it's sometimes called the universal blood donor type.
What blood component is normally transfused to trauma patients?
Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets.
What are the types of blood products?
Blood ProductsRed blood cells.Platelets.Plasma.Cryoprecipitate.Antibodies.White blood cells.Blood substitutes.
What blood products are used for transfusion?
In transfusion medicine, several blood products can be prepared and used as replacement therapy; however, four of these products are more commonly used in general practice: RBCs, fresh frozen plasma (FFP), platelets and cryoprecipitate.
What is blood O type?
38% of the population has O positive blood, making it the most common blood type. O positive red blood cells are not universally compatible to all types, but they are compatible to any red blood cells that are positive (A+, B+, O+, AB+).
Why is type O blood universal donor?
People with type O- blood are called universal donors because their donated red blood cells have no A, B or Rh antigens and can therefore be safely given to people of any blood group.
Is type O blood universal?
Group O can donate red blood cells to anybody. It's the universal donor.
Which type of fluid resuscitation should be administered to a patient with 4 units of blood loss?
The resuscitation should occur before, or concurrently with, any diagnostic studies. Crystalloid is the first fluid of choice for resuscitation. Immediately administer 2 L of isotonic sodium chloride solution or lactated Ringer's solution in response to shock from blood loss.
Is albumin a blood product?
Albumin is a plasma-derived blood product.
Can you give Prbc and platelets together?
Yes, unless otherwise stated in the instructions for use on the blood tubing packaging you can transfuse red blood cells, platelets, plasma or cryo through the same filter set. However, the products should be transfused sequentially not simultaneously. 16.
Efficacy of Antifibrinolytic Agents
After the first study in 1987, 9 more than 70 randomized, controlled trials that included from 20 to 796 patients (median, 75) confirmed and established the efficacy of aprotinin for limiting the requirements for transfusion of red cells, platelets, and fresh-frozen plasma in patients undergoing cardiac surgery.
Safety of Antifibrinolytic Agents
There have been criticisms that many trials of the efficacy of aprotinin in cardiac surgery were unnecessarily carried out (and reported) after the transfusion-sparing efficacy was unequivocally established and that such studies should have focused instead on the more cogent and unsettled issue of safety.
Efficacy of rFVIIa
Initially, rFVIIa was licensed for the treatment of bleeding in patients with hemophilia who had antibodies inactivating factor VIII or IX. 4 More recently, this agent has been used extensively in patients with major hemorrhage from surgery, trauma, or other causes.
Safety of rFVIIa
Controlled clinical trials have shown that the incidence of thrombotic complications among patients who received rFVIIa was relatively low and similar to that among patients who received placebo. 70 However, most studies of rFVIIa involved patients who had impaired coagulation or who were at low risk for thrombosis.
Other Interventions
Desmopressin was originally developed and licensed for the treatment of inherited defects of hemostasis.
Conclusions
The available data broadly indicate that aprotinin, lysine analogues, and rFVIIa are potent hemostatic agents but that desmopressin is less efficacious. Aprotinin and lysine analogues are used almost exclusively for prophylaxis against anticipated major blood loss, whereas rFVIIa is used not only to prevent but also to treat excessive bleeding.
Author Affiliations
From the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and the Department of Medicine and Medical Specialties, University of Milan; the Istituto di Ricovero e Cura a Carattere Scientifico, Maggiore Hospital; and Mangiagalli and Regina Elena Foundation — all in Milan (P.M.M.); and the Department of Medicine and Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam (M.L.)..
What are the parts of blood that are given to patients?
These include red blood cells, plasma, platelets, albumin, or cryoprecipitate.
How many points does hematocrit change after blood draw?
So, if you give a unit of blood and the hematocrit does not change with your post-infusion blood draw, the patient is still bleeding! It should have raised the hematocrit by 3 points.
What is platelet clotting?
Platelets. Platelets are are an essential part of the clotting mechanism of the body. In my experience, I do not see platelets given near as frequently as PRBCs or FFP. Usually our doctors order them if the patient is extremely thrombocytopenic (low platelets) and they are continuing to drop.
What is the hematocrit of PRBCs?
The hematocrit of PRBCs is approximately 55%. This type of blood product is often given in the case of acute bleeding. In the ICU, it seems like the majority of patients receiving PRBCs are GI bleeders or patients with complications from surgery.
What is FFP in blood?
Fresh Frozen Plasma (FFP) One unit of FFP is taken all of the plasma from a unit of whole blood. It contains many factors necessary for clotting and is often given to reverse a patient's INR. When patients receive multiple units of FFP, they are often given Vitamin K to aid in increasing the patient's ability to coagulate.
What is a six pack of platelets?
It seems like usually patients do not have an overwhelming response to receiving platelets. Some of the nurses call one unit of platelets a "six-pack of platelets.". They are referring to just one bag of them.
How does albumin help with renal failure?
Albumin is a protein that helps to draw fluid back into the vasculature through osmotic pressure. The albumin protein pulls more volume into the veins. This can be especially helpful with patients who are in shock or who are in acute renal failure. When patients have decreased urine output, I have seen that the doctors try one of two things: a fluid bolus challenge or albumin administration. Sometimes they will do both. They are hoping that the patient's kidneys respond to the increase in fluid within the vasculature. If this is the case, the patient will start producing more urine and you will know that they are volume depleted. Doctors may order albumin q6 or q8 hours for a certain number of doses.
What is the role of blood in the body?
In addition to blood's components in terms of oxygen transporting red blood cells, blood also transports carbon dioxide, and it contains white blood cells to combat infection, clotting factors and essential blood proteins. There are four blood types each of which has its antigen in its red blood cells.
Which blood type has antibodies?
Each blood type also has antibodies, which are referred to as agglutinins. Type A blood has B agglutinins; type B blood has A agglutinins, type AB blood has no antibodies, or agglutinins, and type O blood has both A and B agglutinins. People also have a rhesus, or Rh, factor antigen or the lack of it. Clients with an Rh positive blood, which is the ...
What is hemolysis in blood?
Hemolysis occurs as the result of an incompatibility of the donor's and recipient's blood which is referred to as an ABO incompatibility. This incompatibility can occur as the result of a laboratory error in terms of typing and cross matching and a practitioner error in terms of checking the blood and matching it to the client's blood type. This complication is signaled when the client has flank pain, chest pain, restlessness, oliguria or anuria, respiratory distress, brown urinary output, hypotension, fever, low blood pressure and tachycardia. The treatment of hemolysis includes the administration of normal saline after the transfusion is stopped and all the tubing is changed to prevent kidney failure and circulatory collapse. Although rare, a delayed, rather than an acute and immediate, hemolytic reaction can occur up to about 4 weeks after the transfusion. This delayed reaction is not as severe as an acute hemolytic reaction and it is characterized with jaundice, discolored urine and anemia.
What is albumin used for?
Albumin: Albumin is administered to clients who need expanded blood volume and/or plasma proteins. Clotting factors and cryoprecipitate: Clotting factors and cryoprecipitate are administered to clients affected with a clotting disorder including the lack of fibrinogen.
What is the first thing a nurse must do when a reaction or a complication is possible?
The first thing that the nurse must do when a reaction or a complication is possible is to discontinue the administration of the blood or blood product.
How many blood types are there?
There are four blood types each of which has its antigen in its red blood cells. These blood types are A with A antigens, B with B antigens, AB with both A and B antigens, and O which has neither A nor B antigens. People with O type blood are universal donors but they are universal suckers because type O blood can be given to clients with A, B, ...
When to use a packed red blood cell?
Packed red blood cells: Packed red blood cells are used when the client is in need of increased oxygen transporting red blood cells as may occur post operatively and with an acute hemorrhage.
Abstract
Massive hemorrhage is associated with coagulopathy and high mortality. The transfusion guidelines up to 2006 recommended that resuscitation of massive hemorrhage should occur in successive steps using crystalloids, colloids, and red blood cells (RBCs) in the early phase and plasma and platelets in the late phase.
Introduction
Death from injury has increased by 20% over the last decade and accounts for more death than malaria, tubercolosis, and HIV combined.
The hemostatic system and its monitoring
The classical cascade model of coagulation that was introduced >50 years ago 15, 16 was in 1994 replaced by the cell-based model of hemostasis, emphasizing the importance of tissue factor as the initiator of coagulation and the importance of cellular elements, ie, platelets, for intact hemostasis.
The Copenhagen concept
In 2005, we suggested that administration of plasma and platelets, together with RBCs, from the start of resuscitation would be beneficial in massively bleeding patients.
The Houston concept
The concept we use in Houston is derived from the experience on the battlefield, supported by serial military and civilian studies identifying best practices. 9, 26, 27, 31-33 Before reaching the hospital, we liberally use tourniquets, hemostatic dressings, and hypotensive resuscitation in efforts to minimize and prevent ongoing blood loss.
Discussion
The optimal way to resuscitate massively bleeding patients remains elusive, and adequately powered clinical trials addressing this topic are lacking.
Summary
Considering the high, and potentially preventable, mortality of massively bleeding patients, it is a prerequisite that a multidisciplinary team of hematologists, surgeons, emergency medicine, anesthetists, and blood bankers jointly develop and implement MTPs, together with clear indications for when this should be activated, stopped, and by whom.
