Table 1.

Postoperative transfusion guidelines.

RCB tranfusion Acute blood loss exceeding 15% blood volume Acute blood loss with hemodynamic instability or evidence of inadequate oxygen carrying capacity Hemoglobin <10 g (Hct 30%) and ongoing bleeding Hemoglobin <7 g (Hct 21%) Systemic anemia (regardless of hemoglobin levels) Hemoglobin <10 g in special risk groups of cardiovascular disease

Platelet transfusion Prophylactically for platelet count <20,000 Active bleeding and platelet count <60,000 Platelet count <60,000 during or shortly after surgery Active bleeding in a patient with proven or suspected platelet dysfunction Massive transfusion with diffuse microvascular bleeding

Fresh frozen plasma transfusion Active bleeding due to coagulopathy (PT >14 seconds or PTT >40 seconds and not due to isolated factor VIII or fibrinogen deficiency Prophylactically in patients at risk for a bleed that would cause serious clinical sequelae and PT >14 seconds or PTT >40 seconds Massive transfusion with laboratory or clinical evidence of coagulopathy

Cryoprecipitate transfusion Hypofibrinogenemia <100 mg/dL Recent thrombolytic therapy Anticipated defibrination following cardiac surgery and fibrinogen <150 mg/dL

RBC, red blood cell; Hct, hematocrit; PT, prothrombin time; PTT, partial thromboplastin time.