Blood Products Breakdown
Apr 25, 2025
π©Έπ§ͺ𧬠Blood unpacked - blood products ππ©Ήπ
Administration of blood products is a somewhat frequent occurrence in the perioperative environment π₯, particularly in the case of trauma patients π. But do you know what exactly those blood products are and where they come from? Let’s break it down! ππ§«
π₯ Red cells π§¬π
The purpose of red cell transfusion is to improve oxygen delivery to the tissues by increasing haemoglobin π¨π§ . One unit of red cells typically increases haemoglobin by around 10g/L π. Red cells can be prepared in a number of different ways, the most commonly used preparation being packed red cells (PRC) - where a significant portion of plasma is removed from a unit of whole blood π©Έ.
Other preparations include microaggregate-free blood, irradiated red cells β’οΈ and leucocyte depleted red cells π§Ό. These are generally used in patients to avoid reactions to things like leucocytes, and in immunocompromised patients π‘οΈ.
π‘ Platelets π§«π©Ή
Platelets are essential for the initiation of the coagulation cascade and primary haemostasis π§©π§¬. They can be collected in two different ways:
Pooled platelets - units of platelets collected from 4-6 donors are pooled together in a single pack, often used for thrombocytopenic patients π§.
Apheresis platelets - collected from a single donor through an apheresis machine which removes the platelets and returns the remaining blood to the donor ππ.
π§ Fresh frozen plasma (FFP) π§π§ͺ
FFP is also used to replace coagulation factors in patients experiencing excessive bleeding and/or coagulopathy π§β οΈ. FFP is collected through a process of spinning whole blood, known as centrifugation π, which separates the plasma from the red cells π§ͺ. FFP is kept frozen to prevent the loss of coagulation factors βοΈ, and once thawed is best used immediately β±οΈ.
𧬠Cryoprecipitate βοΈβοΈ
When FFP is thawed, a precipitate rich in proteins, including factor VIII, fibrinogen and von Willebrand factor is formed - this is known as cryoprecipitate π§. Cryo is indicated for use in patients experiencing excessive bleeding where fibrinogen concentrations are reduced π, and patients undergoing massive transfusion where fibrinogen concentrations cannot be measured in a timely manner β. It is also used in patients with von Williebrand’s disease and other fibrinogen deficiencies π§¬.
π Plasma derivatives π§ͺπ
Once most of the cellular material and coagulation factors have been removed from plasma, the remaining solution is Albumin π§. Available in 4.5% and 20%, albumin is used to help restore circulating blood volume for patients π.
Other plasma derivatives include immunoglobulin π‘οΈ, used for a variety of reasons in autoimmune and inflammatory diseases π₯, as well as passive immunisation against particular infections π¦ .
π§ͺ Coagulation factors π§¬π
Individual coagulation factors can be administered to patients to treat specific factor deficiencies π§«. These factors include Recombinant factor VIII and factor IX, and Factor II, VII, IX and X concentrate - also known as prothrombinex, which is used in warfarin overdose and cases of major bleeding π¨.
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References:
Association of Anaesthetists (2016). The use of blood components and their alternatives. ASA. https://anaesthetists.org/Home/Resources-publications/Guidelines/Blood-components-and-their-alternatives
Herbert, L. (2012) Blood component therapy. WFSA. https://resources.wfsahq.org/atotw/blood-component-therapy-anaesthesia-tutorial-of-the-week-262/
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