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Blood Transfusion Therapy Data
Administration of Blood Components
Darrell J. Triulzi, MD (ed)
Copyright © 1981, 1993, 1996, 1999
American Association of Blood Banks,
8101 Glenbrook Road,
Bethesda,
MD
20814
I. Positive Identification of the
Recipient To Be Transfused and the Designated Blood
Unit To Be Used Is Essential.
II. Compatibility of Red Blood Cells
with IV Solutions:
1. Use 0.9% Sodium Chloride for Injection, USP.
2. DO NOT use 5% Dextrose solutions (may induce hemolysis).
3. DO NOT use Lactated Ringer's (contains Ca++ which may
induce clot
formation in the blood bag and/or administration set).
4. Add NO medications to blood.
5. Plasma (type compatible) or Albumin (5%) are acceptable in special
circumstances.
III. Blood Warming. Use only a
temperature monitored blood warmer to avoid hemolysis.
Indications for blood warming:
1. Adults receiving blood
over 50/kg/hour.
2. Children receiving blood over 15/kg/hour.
3. Patients with clinically active cold agglutinins.
4. Rapid infusion of blood through central lines (cold blood may
induce arrhythmias).
IV. Blood Filters. ALL BLOOD
COMPONENTS MUST INFUSED THROUGH A FILTER.
1. Use a standard blood filter (170 260 micron
screen) for all blood components.
2. Leukocyte reduction filters are used to:
a. Decrease febrile transfusion reactions.
b. Decrease risk of alloimmunization to leukocyte or HLA
antigens.
c. Reduce CMV transmission (proper technique is critical).
V. Time Limits for Infusion.
Components should be infused within 4 hours;
Note: the
blood bank can divide components into aliquots as needed.
VI. Irradiation of Blood and Cellular
Components.
A minimum of 25 Gy should be
used to reduce the risk of TA-GVHD in susceptible patients such as:
selected immunoincompetent or immunocompromised recipients (ie,
hematopoietic progenitor transplant congenital immune deficiency, etc),
a fetus receiving intrauterine transfusions, recipients of donor unit:
from blood relatives, recipients of HLA matched platelets.
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