VABS Product Description
Packed Red Blood Cells, Canine
Volume: ~120 - 240ml/unit, The volume varying with the Packed Cell Volume of the donor. The exact volume of each bag is indicated on the label.
Description: Packed Red Blood Cells (PRBCs) are obtained by separating the cells from CPD anticoagulated whole blood. Cells are suspended in a solution of OPTISOL, a red cell preservative.
Indications: PRBCs are indicated in the treatment of symptomatic normovolemic anemia of many causes. They are especially useful in situations where volume overload is a concern, and can also be used with other component therapy in whole blood loss.
Storage: PRBCs with OPTISOL may be stored at refrigerator temperatures (1 to 6° C) for up to 42 days. The expiry date is indicated on the label. DO NOT FREEZE. The bags should be stored with a small amount of space between the bag and surrounding structures to allow the bag to “breathe”. It is recommended the units be stored in a refrigerator which is not frequently opened. A thermometer that can be read from outside the refrigerator should be checked twice daily.
Precautions: This product is more likely to induce hypersensitivity reactions than plasma products. As a result, blood typing the recipient and cross matching with donor PRBCs prior to transfusion are strongly recommended. Small volumes of blood have been aliquoted within the line attached to the bag for this purpose. Do not use units containing large clots, those whose contents are chocolate/black color or are exhibiting gross hemolysis. Do not use units which have passed their expiration date.
Administration: **ALL BLOOD PRODUCTS MUST BE ADMINISTERED THROUGH AN APPROPRIATE FILTER** Connect the recipient filter administration set to the unit by spiking one port. Directions for use are on the filter package. Use a Hemo-nate® filter if a small volume (< 60 ml) is being transfused. Gently rock the bag to mix the contents. If needed, 50 – 100 ml of 0.9% saline (ONLY) can be added to the unit to improve ease of administration. DO NOT USE LRS or any Calcium (Ca++) containing fluid in the same IV line as blood products, as the Ca++ may chelate with the citrate in the anticoagulant, allowing blood to clot.
Rewarming of the entire bag of PRBCs to body temperature is neither necessary nor recommended. Administration of the product may be initiated immediately upon removal from a refrigerated environment if the administration line is run through a warm waterbath (37°) before it reaches the patient. Volume to be administered will be dependent on desired increase in PCV. The percent rise to be expected from 1 unit can be roughly calculated: 1 ml PRBCs per kg of recipient body weight will raise the PCV approximately one percent. (Obviously, this will be affected by hydration status or ongoing RBC loss.) Example: 150 ml PRBCs given to a 10 kg dog should result in ~15% increase in PCV.
Start the transfusion slowly (0.25 ml/kg) for the first 30 minutes while monitoring the patient’s temperature, HR and RR immediately prior to starting the transfusion, and repeat at 15 and 30 minutes. If there is no reaction, the rate can be increased to 5 - 10 ml/kg/hr, monitoring TPR every 30 minutes. In emergent situations much higher rates have been used, up to 22 ml/kg/hr. A suggested maximum dose is 22 ml/kg/day. Transfusion rate and volume administered depend on the clinical condition and volume status of the patient, so no general guidelines will apply to all patients. The veterinarian giving the transfusion must assess each individual recipient closely and base the administration on the patient’s status. The unit should be administered over no MORE than 4 hours (because of risk of bacterial growth in the unit once it is spiked). If the unit is spiked but not warmed (e.g. smaller volume removed for administration) it can be kept refrigerated up to 24 hours.
Adverse reactions: Hypersensitivity reactions may occur during or after the administration of any product containing red blood cells. Patient temperature should be monitored every 30 minutes during the course of the transfusion, as a rise in temperature is often the earliest indicator of a reaction. Other signs may include restlessness, panting, vomiting, facial pruritis, hyperemia, and angioneurotic edema.