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Blood Management in Orthopaedic Surgery

Normal blood volume = 80ml/Kg

Normally produce 15-20ml RBC/day (1g/dl/wk)

Normal patient one unit of blood can be produced in 72 hours

Red cell life=120d, Platelet life=10d, WBC life=7hrs.

FFP: give 1U with 4th U of blood then 1U per 2U blood.

Platelets: give 6U after 10U of blood. 1U raises platelets by 10x109.


BLOOD PRODUCTS

A 'unit' (U) = the quantity obtained from a single blood donation.

Shelf life: whole blood (CPD-A1)= 35d, FFP=1yr, Platelets=5d.

Whole blood

  • a source of blood components, is now considered more a raw material than a transfusion medium. 

  • Whole blood may be used when improved O2-carrying capacity is needed with volume expansion, eg, for rapid massive blood loss. It is also used for exchange transfusions.

  • 1 unit = 450ml of blood in 63ml of a citrate anticoagulant (CPD-A1)

  • Stored Blood: pH 6.71, Pot 20mmol/l at 21d, incr Sodium, decr 2,3 DPG, WBC inactive after 48hrs, platelets inactive after 24hrs, decr. factors V, VIII, XI, X.



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