Transfusion Products: When and How?

Transfusion therapy is becoming more widespread. Products include fresh and stored whole blood, packed red blood cells, fresh-frozen plasma, cryoprecipitate, and platelet products. A range of conditions that can benefit from transfusion therapy are discussed, such as hemorrhage, coagulopathy, hyperproteinemia, thrombocytopenia, hemophilia A, anemia, and shock. Hemoglobin-based oxygen carriers reduce risk for transfusion reaction in patients with acute hemorrhage and immune-mediated anemia. Because administration of blood products has the potential to promote a significant immune response, it is important to select the appropriate blood product based on maximum benefit and minimum risk. Understanding component transfusion therapy allows practitioners to select the component appropriate for each situation and to avoid adverse transfusion reactions. This article is not only a continuing education course, it is a guide to current component transfusion therapy, allowing clinicians to more knowledgeably select and use blood products to treat specific diseases. Topics include selecting blood donors (with a discussion of canine and feline blood groups); collecting, handling, preparing, and storing whole blood and components; blood-typing and crossmatching; considerations for administration of blood products; and preventing and managing transfusion reactions. Each blood component and its use in a specific condition are discussed in detail. Charts include a standard operating procedure for crossmatching; a transfusion rate chart with formulas and guidelines; indications for blood products with uses and doses; and a complete chart of immunologic and nonimmunologic transfusion reactions and their management.

COMMENTARY: This is an excellent article on all aspects of transfusion medicine, from choosing donors to dealing with adverse reactions. It includes charts that can be posted for easy access when time is of the essence.

Transfusion medicine. Haldane S, Roberts J, Marks SL, Raffe MR. COMPEND CONTIN EDUC PRACT VET 26:502-518, 2004.