Packed red blood cells

General

• Type: Blood components
• Dosage Forms:
• Common Trade Names:

Adult Dosing

• One unit (250mL) raises hemoglobin by 1 g/dl
  • Usually transfuse at least 2 units at a time (15mL/kg in peds)
• Must transfuse no slower than 1 unit/4hr
  • If require slower transfusion (e.g. risk for volume overload) the pRBC can be split

Special Populations

• Pregnancy Rating:
• Lactation:
• Renal Dosing
  • Adult
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

Types

• Leukocyte reduced
  • Eliminates 70-85% of leukocytes
  • Reduces nonhemolytic febrile reactions
  • Prevents sensitization in patients who may require bone marrow transplant
  • Minimizes risk of HIV and CMV infection
• Irradiated
  • Eliminates capacity of T-cells to proliferate (prevents graft-versus-host disease)
  • Consider in transplant patients, neonates and immunocompromised patients
• Washed
  • Indicated for patients with hypersensitivity to plasma (such as IgA deficiency)

Indications

• Hgb <6 g/dL: Recommended except in exceptional circumstances
• Hgb 6 to 7 g/dL: generally likely to be indicated
• Hgb 7 to 8 g/dL: should be considered in postoperative surgical patients, including those with stable cardiovascular disease, after evaluating the patient’s clinical status
• Hgb 8 to 10 g/dL: generally not indicated, but should be considered for some populations (eg, those with symptomatic anemia, ongoing bleeding, acute coronary syndrome with ischemia)
• Hgb >10 g/dL: generally not indicated except in exceptional circumstances

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Hypocalcemia due to citrate (massive transfusion protocols) - check ionized calcium levels

Pharmacology

• Half-life:
• Metabolism:
• Excretion:
• Mechanism of Action:

Comments

• Can give type O Rh-positive pRBCs to a man or woman no longer of child-bearing age

See Also

• Transfusions
• Massive Transfusion Protocol

References

Authors

Ross Donaldson