7.3 Type of blood product

7.3.1 Fresh whole blood: 

This is used as soon as possible after collection. It is indicated in those patients who have low hemoglobin and also a low platelet count, less than 40,000/mm3. Such patients are:

• Those with thrombocytopenia (low platelet count) who are bleeding.
• Those who have received a massive transfusion with stored blood and who are low in platelets and labile clotting factors.

7.3.2 Packed Cells: 

These are prepared by centrifuging whole blood and removing 200ml of plasma per unit. Packed cells have a volume of 300ml and a shelf life of 21 days at 4°C. Each unit of packed cells raises the Hb by 1-1.5g /dL.

Indications for packed cells

• Chronic anemia in the normovolemic patient whose circulation must not be overloaded
• Patients with cardiac failure
• Very old patients
• Those with chronic sepsis

Packed cells can be transfused along with normal saline or colloid and used in the treatment of shock. Since packed cells contain only about 80ml of plasma (as compared to 250ml of plasma in whole blood) the amount of antibodies introduced into the patient and hence the incidence of adverse reactions is reduced.

7.3.3 Fresh frozen plasma

This is prepared from whole blood within 6 hours of collection. It is frozen immediately and hence carries the labile clotting factors V and VIII. It has a shelf life of 3 months at -20°C and 1 year at -30°C. Thawing of fresh frozen plasma must be done gradually. It takes 30 minutes at 37°C to thaw and it must be infused soon after thawing.

Indications for the use of fresh frozen plasma: Replacement of clotting factors:

• After massive transfusion
• In hemophilia
• Following anticoagulant overdose
• DIC (Disseminated Intravascular Coagulation)
• Bleeding from liver disease