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Simple CPB Transfusion Criteria

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bvlich View Drop Down
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Joined: Jan 01 2006
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Posts: 20
  Quote bvlich Quote  Post ReplyReply bullet Topic: Simple CPB Transfusion Criteria
    Posted: Jan 16 2008 at 10:46am
I am interested in defining some simple, straight-forward RBC transfusion guidelines for cardiopulmonary bypass.
 
I would apprecite feedback from the perfusion community on this subject.
 
Transfusion Criteria (RBC):

 

A.            Transfusion of RBC’s should be considered while on CPB only if the following transfusion criteria are met:

 

1.             The patient’s dilutional-adjusted hematocrit (Hct) falls below 21%.

 

2.             The patient’s calculated dilutional Hct will be less than 21% upon initiation of CPB.

 

3.             There is active bleeding or uncontrolled surgical hemorrhage.

 

4.             There is no autologous blood available, no “cell saver” blood to process, and there is insufficient volume for hemoconcentration.

 

5.             The patient’s venous saturation falls below 60% and cannot be raised by increasing the perfusion flow rate.

 

6.             The patient’s cerebral oxygen saturation falls below the “device specific” target threshold and cannot be cannot be increased by other corrective measures.

 

7.             The attending surgeon or anesthesiologist gives a direct verbal order.

 

B.            RBC’s should be ordered and transfused one (1) unit at a time unless profound anemia exists or there is active bleeding or uncontrolled surgical hemorrhage.

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