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Plasma Transfusion

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Plasma transfusions can be performed in any hospital. Our Blood Bank Director Jill Greene, CVT, shows you how to set up and monitor a patient receiving a plasma transfusion.

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Jill Greene's picture
Jill Greene

CVT

Enrolled: 08/2011

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Beth Armstrong's picture

Heska actually doesn't recommend running blood products through those pumps. I actually looked that up earlier this week because I wasn't sure.

Jill Greene's picture

Hi Beth, thanks for the comment. While it's true that Heska does not recommend using their pumps for blood products, we have done some outside research with large animal blood banks that shows they are an acceptable pump for use in blood transfusions. You should always follow your hospital's policy on which pumps to use for any products you will be infusing to your patient.

-Jill G.

Debrah McDonald's picture

Hi Jill, do you have any info on the research you mentioned? We're currently having the same debate at our hospital and I'd love to gather all the information available.

Jill Greene's picture

Hi Debrah, I understand this issue comes up in many hospitals. We spoke with Anne Hale (previously of Animal Blood Resources Int) about using the Heska pump and she determined that it was an acceptable pump for delivering blood components. Ideally, blood should be delivered by gravity without a pump. However, it can be difficult to monitor the quantity transfused by counting drips, especially in a busy practice. We often start an animal on the Heska pump, giving the blood slowly for the first 15 minutes while monitoring for a transfusion reaction. Then if all goes well, we will speed up the transfusion to as fast as the patient can tolerate, using gravity drip. You can refer to this article about methods of delivering blood products: JVECC 21(3) 2011 pp 209-216; Influence of transfusion technique on survival of autologous red blood cells in the dog.

Stephanie  Cowan 's picture

We are having a debate currently about the proper procedure to thaw FFP. We have a set policy in place, which basically entails placing the FFP on the counter until the edges have thawed, then placing it into zip loc bags and into the fluid warmer (which is kept at 96 deg F). We had a critical dog bleeding out and had to rush warm the plasma. Would love to hear your thoughts.

Megan Agnello's picture

In regards to delivering blood products with different IV fluids, I am only aware of the concerns with calcium, hypotonic solutions such as D5W or hypertonic solutions. From what I have read Norm-R and Plasma-Lyte are compatible with blood products, LRS is the IV fluid that is never used. Can you comment further on your reasoning for strict use of sodium chloride solutions.

Megan Brashear's picture

Stephanie, in regards to thawing, we take our plasma directly from the freezer, double bag it in ziplock freezer bags, and place it in a warm water bath with the water at 98.6 degrees. This will thaw a unit in about 30min. Placing it on the counter may help thaw the bag so it doesn't break if if moved, but that can add time to the thaw process. Anything too warm will start to cook the proteins and may compromise the efficacy, so we don't recommend anything hotter or faster.

Megan Brashear's picture

Megan, you are correct, it is the calcium in LRS that should never be mixed with blood products (mixing the calcium can cause clots to form in the line) but in our hospital we say only mix with NaCl and we never have any problems. When there are exceptions to the rule (okay to mix blood products with crystalloids except LRS or except with xyz additives)then mistakes can happen, so across the board we stop all crystalloids through the same IVC as the blood and we don't have any problems.

Jennifer Herberg's picture

Do you feed the blood filter line through the pump or a thinner extension set line? I am worried that the blood filter set is so thick it will not be accurate in delivery...however flushing a bunch of extension sets post transfusion seems less than ideal as well.