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The Use Of Blood Products In The Critically Ill Patient: Indications And Risks

January 2014

Abstract

It is imperative that emergency physicians have a basic understanding of blood products and the indications and risks associated with their use. Evidence-based, restricted use of blood components in critically ill patients can lead to decreased mortality while avoiding unnecessary morbidity and complications. Recognition of the need for irradiated or leukoreduced components in special populations further reduces adverse events. This issue reviews the preparation of blood components and indications for their use, infusion of products, and the determination of stability after infusion. Infectious and immunologic risks associated with transfusion are reviewed, with special attention given to pulmonary complications, as well as guidelines for comprehensive informed consent. Massive transfusion protocols and the use of oxygen-carrying substitutes are also discussed.

Key words: blood transfusion, blood component transfusion, acute lung injury, blood coagulation factors, informed consent, transfusion-related acute lung injury, hemorrhage, hemorrhagic shock, transfusion-associated circulatory overload, fresh frozen plasma, acute hemolytic transfusion reaction, febrile nonhemolytic transfusion reaction, transfusion-associated graft-versus-host disease

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