Emergency Medicine Book

//fpnotebook.com/

Blood Product

Aka: Blood Product, Blood Product Irradiation, Blood Product Leukocyte Reduction, Leukoreduction of Blood Product, Blood Product Washing, Blood Product Volume Reduction, Blood Product Pathogen Inactivation
  1. See Also
    1. Colloid Solution
    2. Intravenous Fluid
    3. Isotonic Saline
    4. Blood Transfusion (pRBC, Packed Red Blood Cells)
    5. Platelet Transfusion
    6. Plasma Transfusion (Fresh Frozen Plasma, FFP)
    7. Cryoprecipitate
    8. Transfusion Complication
    9. Sodium and Water Homeostasis
    10. Emergent Reversal of Anticoagulation
  2. Definitions
    1. Blood Product
      1. Native blood component acquired from a donor, that is processed for transfusion into a recipient
      2. Includes Packed Red Blood Cells (pRBC), Fresh Frozen Plasma (FFP), Platelets and Cryoprecipitate
  3. Epidemiology
    1. Prevalence in U.S.
      1. More than 16 million units of Blood Product are transfused every year in the United States
  4. Types: Blood Product Modifications
    1. Background
      1. Modifications to Blood Products reduce complications, esp. in those patients at risk
    2. CMV Risk Reduction
      1. Indicated in pregnancy and severe immunocompromised states
      2. Limits donors to CMV negative or supplies Leukocyte reduced blood
    3. Hemoglobin-S Negative Blood Products
      1. Indicated in Sickle Cell Anemia patients
      2. Limits donors to non-sickling Hemoglobin
    4. Irradiation
      1. Indicated in severe immunocompromised states
        1. Indicated in Hematologic Malignancy, Bone Marrow Transplant, inherited cellular immune deficiency
        2. NOT indicated in HIV, Sepsis, Solid Organ Transplant or solid metastatic cancer
      2. Prevents T Lymphocytes from replicating
      3. Prevents Transfusion Associated Graft Versus Host Disease (TAGVHD)
    5. Leukocyte Reduction (Leukoreduction)
      1. Reduces Leukocyte concentration in Blood Products (pRBC, Platelet Transfusion)
      2. Typically standard for Red Blood Cell Transfusions to be Leukocyte reduced
      3. Decreases risk of Febrile Nonhemolytic Transfusion Reaction (FNHTR)
      4. Decreases risk of CMV Infection
    6. Pathogen Inactivation
      1. UV-Light mediated destruction of pathogens with nucleic acids (does not replace other donor screening methods)
      2. Similar results to Irradiation
      3. Pathogen Inactivation is only available for Plasma Transfusion and Platelet Transfusion
    7. Volume Reduction
      1. Acellular fluid reduced (concentrating Blood Product)
      2. Decreased risk of several Transfusion Complications
        1. Transfusion Associated Circulatory Overload (TACO)
        2. Febrile Nonhemolytic Transfusion Reaction (FNHTR)
        3. Allergic Transfusion Reaction
        4. Hemolytic Transfusion Reaction
        5. Hyperkalemia
      3. However, volume reduction has downsides (similar to washing)
        1. Decreases Blood Product shelf-life
        2. Requires increased blood bank staff time for processing
    8. Washing
      1. Replaces non-cellular fluid in cellular Blood Products
      2. Indicated in history of severe Allergic Transfusion Reaction or IgA deficiency
      3. Also indicated to sensitivity to extracellular Hemoglobin or Potassium
      4. Decreased risk of several Transfusion Complications
        1. Febrile Nonhemolytic Transfusion Reaction (FNHTR)
        2. Allergic Transfusion Reaction
        3. Hyperkalemia
      5. However, washing has significant downsides
        1. Decreases Blood Product shelf-life (activates platelets, hemolyzes Red Blood Cells)
        2. Requires increased blood bank staff time for processing
  5. Types: Packed Red Blood Cells (pRBC)
    1. See Blood Transfusion (pRBC, Packed Red Blood Cells)
    2. Contains 200-250 ml per unit pRBC
    3. Increases Hematocrit 3% per unit pRBC
    4. Increases Hemoglobin 1 gram/dl per unit pRBC
    5. Indication
      1. Hemorrhagic Shock
      2. Hypovolemic shock despite 40 ml/kg crystalloid
      3. Hemoglobin <7 to 8 g/dl
      4. Coagulopathy
  6. Types: Fresh Frozen Plasma (FFP)
    1. See Plasma Transfusion (Fresh Frozen Plasma, FFP)
    2. Contains 200-250 ml per unit
      1. Contains all Clotting Factors
      2. Does not contain platelets
    3. Dosing: 10-20 ml/kg
    4. Increases Fibrinogen 7-10 mg/dl per unit
    5. Prothrombin Complex Concentrate (PCC4) has largely replaced FFP for Warfarin Emergent Reversal of Anticoagulation
    6. Indications
      1. INR >1.5 to 1.6 AND
      2. Active bleeding or high risk of bleeding
  7. Types: Cryoprecipitate
    1. See Cryoprecipitate
    2. See Prothrombin Complex Concentrate (PCC4)
    3. Contains 50 ml/unit
      1. Contains Fibrinogen
      2. Contains Factors V, VIII, XIII, vWF
    4. Increases Fibrinogen up to 100 mg/dl per unit dose (15-20 ml per 5-7 kg body weight)
    5. Indications
      1. Hypofibrinogenemia (Fibrinogen <100-150 mg/dl)
  8. Types: Platelets
    1. See Platelet Transfusion
    2. Contains 50 ml/unit
    3. Increases platelets 30,000/ul to 50,000/ul per 2.0 m2 BSA per 6 pack (one Platelet Apheresis Unit)
    4. Indications
      1. Platelet Count <50,000 AND Surgery or childbirth (other cut-offs vary between 10-20,000) OR
      2. Massive Transfusion protocol
  9. Adverse Reactions
    1. See Transfusion Complication
    2. Hypothermia (warm Blood Products before infusion)
    3. Hypocalcemia
    4. Transfusion Reactions
  10. References
    1. Raval (2020) Am Fam Physician 102(1):30-8 [PubMed]

Blood product (C0456388)

Definition (NCI) Any natural or synthetic composition that replicates the structure or function of a native component of blood.
Definition (HL7V3.0) <p>A manufactured product that is produced from the raw blood oi a donor with the intention of using it in a recipient transfusion.</p>
Concepts Pharmacologic Substance (T121)
SnomedCT 277048006, 30004009, 256364002, 410652009
HL7 BLDPRD
LNC LP32805-1, LP32808-5
Spanish hemoderivado, hemoderivados, hemoderivados (calificador), hemoderivado (producto), hemoderivado (sustancia), producto derivado de la sangre (producto), producto derivado de la sangre
English Blood Product, Blood products, Blood product (general), blood products, blood product, Blood replenisher, Blood products (qualifier value), Blood replenisher, NOS, Blood product (substance), Blood product (product), Blood product
Sources
Derived from the NIH UMLS (Unified Medical Language System)


You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree