411

Table C.1 Blood Products

Whole Blood Products

Product Shelf Life Advantages Disadvantages Comments

A. Whole blood Hct ∼40% CPD = 21 d

Heparin = 24 – 48 h

CPDA-1 = 35 d Additive

solution (AS) = 42 d

1. Provides volume

2. Provides RBCs

3. Provides some coagulation factors

1. WBC, and platelets relatively nonfunctional

unless fresh and unrefrigerated

2. Storage lesion defects

(K+

) in plasma fraction

1. Used for exchange transfusion

2. PRBCs and FFP preferable

for correction of massive

blood loss

3. Heparinized blood not licensed

for use in USA, but used in

other countries

B. Reconstituted whole

blood

Hct variable

24 h 1. Allows preparation of

whole blood from stored

RBCs (packed or frozen)

and FFP

2. Allows preparation of

Group O cells with lowtiter A and B antibody

plasma

1. Time for preparation 1. Use for exchange transfusion

2. Hematocrit may be adjusted

by formula

3. Provides replacement equivalent of fresh whole blood

Formula for reconstitution:

volume of plasma to add =

volume PRBCs × (Hct

PRBCs/Hct desired – 1).

D. Autologous fetal blood 1. Fresh heparinized <4 h

2. CPD = 21 d

3. CPDA = 35 d

4. AS = 42 d

1. Potential immediate

availability in delivery

room or from blood

bank

1. Risk of bacterial contamination

2. Difficult to obtain correct anticoagulant blood

ratio

3. Requires anticipatory

preparation for best procedural control

4. Complicated procedure

to perform in DR and

maintain sterility

1. Information on advantages of

autologous blood is limited

2. Properly prepared and tested

banked blood a better choice

if time permits

3. Developing countries exploring use

4. Competition for umbilical

cord banking

5. Consider delaying cord

clamping as alternative

Chapters 43 and 44

Red Cell Products

Products Volume (mL) Shelf Life Advantages Disadvantages Comments

A. PRBCs

Hct 70%–75% in

CPDA-1

Hct 55%–60% in additive solutions (AS)

1. CPDA-1 = 250

2. AS = 350

1. CPDA-1 = 35 d

2. AS = 42 d

1. Readily available

2. Easy to prepare

1. Accentuated storage

lesion defects if unit

is at end of shelf life

2. Less RBC mass/mL

of transfused product, if PRBCs in

additive solutions

are used

1. Principal use for correction of anemia

2. With sterile connecting device, can

remove aliquots for

transfusion

3. If only AS products

available, hard pack

for massive transfusion or for exchange

transfusion

Appendix C

(continued )