Makindo Medical Notes.com

Related Subjects: Blood Products - Platelets

Maintain Platelets > 50,000 x 10 (/L in bleeding states and higher for CNS bleeds

About

• Platelets are derived from the buffy coat of whole blood donations.
• A pooled platelet concentrate includes pooled buffy-coat derived platelets from four whole-blood donations suspended in platelet additive solution and plasma of one of the four donors.
• It contains 240000 platelets pooled from 4-6 donors. A Single donor platelet is derived from a single donor by a process of apheresis.
• In view of the lesser number of donors and the theoretical advantage of involving a single-donor platelet (SDP) may be preferred over the use of platelets from multiple donors. A SDP, may contain at least 55000 platelets.
• Some of the important characteristics of platelet transfusions include storage at 20-24 degree Centigrade with constant agitation for 5 days, the need to be transfused within 4 hours of collection, at a rate, not less than 30 minutes.
• Based on the various indications and available guidelines, the following are the indications for transfusion of platelets
• 4 units of platelets are usually given over 30 to 60 minutes (a250ml pooled or apheresis bag).
• Check platelet count 1 hour post-transfusion for increment if pre-surgery or procedure.
• In general blood group-specific platelets are given. If these are not available group compatibility will be given. Rhesus negative platelet concentrates should be used for Rhesus negative patients.

The indications for the transfusion of Platelets include the following:

• Active bleeding in the presence of platelet defects.
• Platelet count of <50,000 /mm3 in patients with active bleeding.
• Active bleeding associated with dengue, malaria, kala-azar and autoimmune platelet disorders
• Patients with platelet counts <20,000 /mm3, in the presence of risk factors
• Patients with platelet counts <10,000/mm3 with no risk factors.
• In patients needing surgical or any other interventions:
• Platelet count <50,000/mm3, if there is minimal risk of bleeding
• Platelet <100,000/mm3, for any ophthalmic or central nervous system surgeries. (some suggest lower 70-80)
• Part of massive transfusion protocol as specific blood component therapy
• In severe uncontrolled bleeding, post cardiopulmonary by pass

References

• Transfusion Triggers for Platelets and Other Blood Products