Fresh Whole Blood (FWB) |
Blood collected from donor without processing |
RBCs, WBCs, platelets clotting factors, all components of plasma |
Acute hemorrhage (especially trauma); need for multicomponent therapy; life-threatening thrombocytopenia |
20 mL/kg raises recipient´s PCV by 1%
VT (mL) = BW (kg) x BV (mL/kg) x [(desired PCV-recipient PCV)/donor PCV]
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10 mL/kg of FWB is expected to raise the platelet count by about 10,000/μL
Should be used in 4-6h because platelets and clotting factors lose activity
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Stored Fresh Blood |
FWB stored up to 4 weeks |
Same as FWB except without platelets and with decreased concentration of some clotting factors, in particularly the labile coagulation factors V and VIII |
Same as FWB (except in cases of thrombocytopenia); in hemophilia A, it is preferable to use FWB than stored FB, especially if the latter is stored > 24h |
Same as FWB |
Storage decreases factors V and VIII, especially if storage is longer than 24 hours and at temperature of 4ºC. Platelets do not survive refrigeration.
For critically ill patients, preference should be to use younger units to prevent injury associated with storage lesions (see Blood Product Storage, below) |
Packed Red Blood Cells (pRBCs) |
RBCs centrifuged with most plasma discarded |
RBCs, may have WBCs |
Anemia, in patients that are normovolemic, without the need of coagulation factors and/or that are susceptible to volume overload |
See Preparing to Administer Blood Products, in Part 3 |
For critically ill patients, preference should be to use younger units to prevent injury associated with storage lesions (See Blood Product Storage, below) |
Leukoreduced pRBCs |
Same as pRBCs, but WBCs removed before storage |
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Same as pRBCs |
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Leukoreduction may decrease immunomodulation and nonhemolytic febrile transfusion reactions |
Fresh Frozen Plasma (FFP) |
Plasma obtained from FWB and frozen in the first 8 hours and <1 year age |
Coagulation factors; anticoagulant factors such as antithrombin; albumin; immunoglobulins |
Inherited and acquired coagulopathies; prophylaxis before invasive procedure in patient known to have a specific coagulation factor deficiency |
10-30 mL/kg (higher in vWD and hemophilia A) |
May be used in acute necrotizing pancreatitis and DIC; management of endothelial dysfunction in sepsis and hemorrhagic shock |
Frozen Plasma (FP) |
Plasma obtained from FWB that was not frozen within the first 8 hours or is stored >1 and < 5 years |
Same as FFP, but without factors V and VIII |
Same as FFP except not hemophilia A. Rodenticide and warfarin-induced coagulopathy |
10-15 mL/kg |
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Cryoprecipitate |
The precipitate containing cold insoluble proteins, formed when FFP is slowly thawed and centrifuged (it can also be obtained through the use of plasma extractor) |
vWF, VIII, XIII, fibrinogen, and fibronectin |
Hemorrhage or prophylaxis before invasive procedures in deficiency of vWF and factor VIII |
1 unit per 10 kg BW |
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Cryoprecipitate-Poor Plasma |
Supernatant that remains after preparation of cryoprecipitate |
Stable coagulation factors II, VII, IX, X; anticoagulant, and fibrinolytic factors; albumin |
Coagulation deficiencies of factor II, VII, IX, or X resulting in active hemorrhage that does not require vWF |
6-12 ml/kg IV over 1-2 hours (rate of administration should not exceed 4 ml/kg/hr in patients with cardiac or renal insufficiency) |
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Platelet-Rich Plasma (PRP) |
Plasma and platelets separated from RBCs after centrifugation |
Platelets and plasma |
Hemorrhage or prophylaxis before invasive procedure in severe thrombocytopenic or thrombocytopathic disorders |
1 unit per 10 kg BW |
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Platelet Concentrate |
Further centrifugation of PRP to have a smaller volume or platelets obtained via plateletpheresis |
Platelets, small amount of plasma |
Same as PRP |
Same as PRP |
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Frozen Platelets |
Platelet concentrate created by plateletpheresis and then frozen using DMSO for platelet stability |
Platelets |
Same as PRP |
Same as PRP |
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Lyophilized Platelets |
Platelet concentrate created by plateletpheresis, followed by stabilization of platelets using aldehyde cross-linking, then lyophilization |
Platelets |
Same as PRP |
Currently under evaluation |
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Lyophilized Plasma |
Plasma that is rapidly frozen, dried and maintained in low temperatures in vacuum |
Same as FFP |
Same as FFP; compared with FFP can be stored at room temperature, transported easily, and reconstituted rapidly in remote and austere environments |
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Studies have shown promise in human medicine; No studies available regarding its use in dogs with the recent products |
Albumin |
Protein is extracted from pooled plasma |
Albumin |
Hypovolemia oncotic support |
Albumin deficit = 0.3 x BW (kg) x 10 (albumin desired - current albumin); 1.5 g/kg |
Human and canine albumin available;
Administration of human serum albumin to dogs and cats is controversial due to safety concerns, in particular the possibility of developing type III hypersensitivity reactions
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Intravenous Human Immunoglobulin |
Pooled IgG extracted from multiple human donors |
Immunoglobulins |
Immune-mediated diseases |
0.5 g/kg/day |
Type I and III hypersensitivity reactions possible |
Specific Clotting Factors and Concentrates |
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Antithrombin; fibrinogen; factors VII, VIII and IX; prothrombin complex concentrates |
Several indications; mostly used in the management of coagulopathies |
Varies depending upon blood product used |
Not yet used or produced in veterinary medicine |