Samwel Mikaye Explains Blood Components and Their Clinical Use
Samwel Mikaye, CEO of SaMik Medical Center, posted on LinkedIn:
”BLOOD COMPONENTS
Blood can be separated into individual components to allow targeted therapy, reduce volume overload, and preserve valuable resources.
1. Whole Blood
β’ Composition: RBCs, plasma, platelets, clotting factors.
β’ Use: Rarely used today; mainly in massive hemorrhage where both RBCs and plasma are needed.
β’ Volume: ~450β500 mL per unit.
2. Red Blood Cells (RBCs) / Packed Red Cells
β’ Composition: Concentrated RBCs, most plasma removed.
β’ Indications:
β’ Symptomatic anemia
β’ Acute blood loss
β’ Hemoglobin <7β8 g/dL in stable patients
β’ Goal: Improve oxygen-carrying capacity.
β’ Volume: ~250β300 mL per unit.
β’ Key point: One unit increases Hb by ~1 g/dL in adults.
3. Platelet Concentrates
β’ Composition: Platelets, some plasma.
β’ Indications:
β’ Thrombocytopenia (<10,000/Β΅L without bleeding)
β’ Active bleeding with low platelets
β’ Pre-surgery prophylaxis if platelets <50,000/Β΅L
β’ Forms: Random donor platelets, apheresis platelets.
β’ Volume: ~50 mL per random donor unit; ~200β300 mL per apheresis unit.
4. Fresh Frozen Plasma (FFP)
β’ Composition: All clotting factors, plasma proteins.
β’ Indications:
β’ Coagulation factor deficiencies (e.g., liver disease, DIC)
β’ Massive transfusion protocols
β’ Warfarin reversal (if urgent)
β’ Volume: 200β250 mL per unit
β’ Storage: Frozen; thaw before use.
5. Cryoprecipitate
β’ Composition: Concentrated clotting factors (Factor VIII, fibrinogen, vWF, Factor XIII).
β’ Indications:
β’ Hypofibrinogenemia (<100 mg/dL)
β’ Hemophilia A (if factor concentrates unavailable)
β’ Massive bleeding with low fibrinogen
β’ Volume: ~10β20 mL per unit
6. Granulocyte/White Cell Concentrates
β’ Composition: Concentrated WBCs
β’ Indications: Rare; for severe neutropenia with infection unresponsive to antibiotics.
β’ Key point: Limited availability, short shelf-life.
General Principles
β’ Cross-matching: Required for RBCs and whole blood.
β’ Compatibility:
β’ O-negative β universal donor for RBCs.
β’ AB plasma β universal donor plasma.
β’ Storage:
β’ RBCs: 1β6Β°C, up to 35β42 days depending on anticoagulant.
β’ Platelets: 20β24Β°C, constant agitation, 5 days.
β’ FFP/Cryoprecipitate: β18Β°C or lower, up to 1 year.
Key Takeaways
1. Blood components allow targeted therapy instead of whole blood.
2. Correct selection depends on deficient element: RBCs β anemia, platelets β thrombocytopenia, plasma β clotting factors.
3. Always monitor patient response and transfusion reactions.”
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