Transfusion quiz Part 2

The average volume is 250-300mL (link)

The average volume is 60-80mL. (link)

PCC contains: 500 Units of factors II, IX, X,; low levels of VII and V; 200 Units of heparin to prevent thrombosis at the injection site and to associate with AT to inhibit clotting factors activated by the manufacturing process; 25 Units of anti-thrombin, an amount too low to interfere with the reversal of warfarin anti-coagulation; and sodium citrate, sodium phosphate and sodium chloride. (link)

The minimum time after administration for PCC to have a major reversal effect on warfarin induced INR prolongation is approximately 15 minutes. (link)

The minimum duration of effect of PCC is approximately 12 hours. (link)

The PCC package contains: 1 vial of prothrombin complex concentrate; 1 vial of 20 mL water for injection; and 1 Mix2Vial™ filter transfer set to enable needle free reconstitution. The recommended administration rate is 3 mL/min (i.e. about 7 minutes for a 500 Unit vial) and administration should be finished within 3 hours of reconstitution. (link)

Cryoprecipitate contains: > 150 Units VIII; fibrinogen > 140 mg, and > 100 Units vWF. It does not contain prothrombin. (link)

The average volume of a unit of cryoprecipitate is 30-40mL (link)

The dose is usually 1 Unit/10kg body weight with administration at 10 mL/min, completed within 1 hour. In a massive transfusion, cryoprecipitate is usually administered after 8 -12 units of packed cells and FFP. (link)

The average volume of a paediatric unit of platelets is 50mL. (link)

The average volume of one adult dose platelets is 250mL, although the volume may vary from 100-400mL. (link)

One adult dose of platelets would normally increase the platelet count in the blood by at least 25 X 10-9/L. Each unit contains at least 200,000 X 10-9 platelets so if the blood volume is 5L, one unit would ideally increase the platelet count by 40 X 10-9/L. However in thrombocytopenia some platelets are immediately used up in plugging endothelial leaks so the real figure is estimated to be closer to 25 X 10-9/L. (link)

In a patient about to undergo neurosurgery (including spinal), or ophthalmic surgery platelets should be transfused until the platelet count is greater than 100 X 10-9/L. The platelet count should be kept above 50 X 10-9/L for other types of surgery. (link)

In a patient with febrile neutropenia, platelets should be transfused to maintain the platelet count greater than 20 X 10-9/L. (link)

In a patient with bone marrow failure who is otherwise currently well, platelets should be transfused to keep the platelet count greater than 10 X 10-9/L. (link)