Table 2.
University of Rochester Medical Center evidence-based transfusion guideline
| Product | Clinical Indication | Transfusion Trigger |
|---|---|---|
| Red blood cells | Anemia | Hct <21%; Hgb <7 g/dL |
| Anemia with acute coronary syndromes | Hct <24%; Hgb <8 g/dL | |
| Platelets | High risk of bleeding | Platelet count <10,000 |
| Fever or sepsis | Platelet count<20,000 | |
| Acute bleeding | Platelet count<50,000 | |
| Intracranial hemorrhage | Platelet count<100,000 | |
| Documented platelet dysfunction | Per platelet function test | |
| Plasma | Urgent need for warfarin reversal | INR >1.7 |
| Clinical coagulopathy | Based on relevant laboratory and TEG values | |
| Acute bleeding | To maintain the RBC to plasma ratio of our MTP | |
| Plasma exchange for TTP | ||
| Factor V or XI deficiency | ||
| Cryoprecipitate | Low fibrinogen level | <150 and bleeding |
| Documented dysfibrinogenemia | Clinically significant bleeding without obvious causation | |
| Uremic coagulopathy unresponsive to DDAVP | ||
| Factor VIII deficiency |
Abbreviations: DDAVP, desmopressin; Hct, hematocrit; Hgb, hemoglobin; INR, international normalized ratio; MTP, massive transfusion policy; TEG, thromboelastography; TTP, thrombotic thrombocytopenic purpura.