++
Product: Whole Blood Administration
Whole blood is given over a maximum of 4 hours through a 170-μm filter1,2,3
++
Preparation/Composition
Donor blood 450–550 mL containing red blood cells (RBCs), plasma, clotting factors, and anticoagulant
Platelets and granulocytes are not functional
++
Indications
RBC replacement in acute blood loss with pronounced hypovolemia
++
Notes
Whole blood is not routinely available and is rarely required in hematology-oncology patients. It is not a source of viable white blood cells (WBCs) or platelets
Shelf life: 21 days in CPD (citrate-phosphate-dextrose); 35 days in CPDA-1 (citrate-phosphate-dextrose-adenine) preservatives
+++
PRODUCT: RED BLOOD CELLS
++
Product: Red Blood Cells Preparation/Composition
RBCs obtained by apheresis collection or prepared from whole blood by centrifugation1,2,3
RBCs collected in CPDA-1 anticoagulant have a hematocrit of 65–80% and a storage volume of 250–400 mL
RBC collections from which plasma has been removed and 100 mL of adenine-containing RBC nutrient solution (eg, AS-1) has been added, have a hematocrit of 55–60% and a volume of 300–350 mL
++
Administration
RBCs are administered over a maximum period of 4 hours through a 170-μm filter
Do not add medications to blood products. If needed to decrease viscosity, 0.9% sodium chloride injection is the only compatible intravenous solution that may be added to RBCs; however, this is rarely needed with current additive solutions
++
Indications
Improves oxygen carrying capacity in anemic patients
In most stable asymptomatic patients without cardiovascular disease, transfusion is initiated if hemoglobin is <7 g/dL
Transfusion thresholds in patients with cardiovascular disease who are asymptomatic are not well defined; results of clinical trials are awaited. Higher transfusion thresholds (9–10 g/dL) may be appropriate for patients with symptomatic cardiac disease3,4,5,6
++
Notes
Patients with febrile nonhemolytic transfusion reactions benefit from leukoreduced blood products
Premedication with acetaminophen 650–1000 mg orally, may also be given
Patients with allergic transfusion reactions are treated with diphenhydramine 25–50 mg orally or intravenously
Shelf life: 35 days in CPDA-1; 42 days if stored in additive solutions like AS-1 (contains sodium chloride 154 mmol/L, adenine 2 mmol/L, glucose 111 mmol/L, and mannitol 41.2 mmol/L)
+++
PRODUCT: WASHED RED BLOOD CELLS
++
Product: Washed Red Blood Cells Preparation/Composition
Washing RBCs with 1 L 0.9% sodium chloride injection (0.9% NS) removes more than 98% of plasma proteins. RBCs are then resuspended in 0.9% NS at an approximate hematocrit of 75%1,2
++
Indications
Patients with a history of severe or recurrent allergic reactions
For patients with paroxysmal nocturnal hemoglobinuria, routine washing of group-specific RBCs is not required
Washed RBCs are used to decrease potassium load in neonates with cardiac or renal disease
++
Administration
Washed RBCs must be transfused within 24 hours
++