Veterinary Clinical Medicine-I (General and Systemic)

Indication for blood component therapy

INDICATION OF BLOOD COMPONENT THERAPY 

Disease	FWB	SWB	PRBCs	PRP	FFP	CRYO
Anemia	x	x	?
Thrombocytopenia/ Thrombocytopathia	x			?
Coagulopathies Acquired & inherited	x				?
Von Willebrand D. & Hemophilia A	x					?

Legend: ? = best component, x = other options, FWB = fresh whole blood, SWB = stored whole blood, PRBCs = packed red blood cells, PRP = platelet-rich plasma, FFP = fresh frozen plasma, CRYO = cryoprecipitate

• For routine transfusion, it is not necessary to warm blood after removal from the refrigerator. Care should be taken to not overheat the blood products while thawing them (<37C). Blood components that have been prewarmed cannot be refrozen/refrigerated. Blood bags are connected to blood infusion sets that have an in-line microfilter. A long (85 cm) blood infusion set with a dripping chamber and a short infusion set (30 cm) for small dogs and cats to connect with syringes are available. Use a latex-free infusion set for platelet administration to avoid platelet aggregation.
• Microfilters with 170µm pores are commonly used to remove clots and larger red cell and platelet aggregates. Finer filters with 40µm pores will remove most platelets and microaggregates.
• Blood components are best administered intravenously. Ideally, an indwelling catheter (16-22 gauge depending on size of animal) is placed into the cephalic or saphenous vein on extremities may be used. In case an intravenous access cannot be obtained, red blood cells and plasma may be administered by intramedullary (or intraosseous) infusion at the trochanteric fossa (or other site). Avoid concurrent administration of drugs or fluids other than physiologic saline through the same catheter in order to prevent lysis of erythrocytes and blood coagulation.