Role of blood products in treatment of disseminated intravascular coagulation (DIC).
| TTP indicates thrombotic thrombocytopenic purpura; HIT, heparin-induced thrombocytopenia; and TRALI, transfusion-related acute lung injury. | |
| RBCs | Keep hemoglobin in range of 6 to 10 g/dL |
| Platelets | Depends on risks for bleeding, not just the platelet count. Risk for bleeding high if less than 20,000–30,000/μL especially if due to decreased production; less so if due to sequestration or shortened platelet survival; nil if due to thrombotic causes (TTP or HIT). In DIC, reasonable target range is 50,000/μL |
| FFP | Enormously overrated in treatment of DIC, especially since recent evolution of our understanding and danger of TRALI. Some indication to supplement RBC transfusions in “total body exchange” situations |
| Cryoprecipitate | Probably best source of fibrinogen. Reasonable target is to keep fibrinogen levels between 50 and 100 mg/dL |
| TTP indicates thrombotic thrombocytopenic purpura; HIT, heparin-induced thrombocytopenia; and TRALI, transfusion-related acute lung injury. | |
| RBCs | Keep hemoglobin in range of 6 to 10 g/dL |
| Platelets | Depends on risks for bleeding, not just the platelet count. Risk for bleeding high if less than 20,000–30,000/μL especially if due to decreased production; less so if due to sequestration or shortened platelet survival; nil if due to thrombotic causes (TTP or HIT). In DIC, reasonable target range is 50,000/μL |
| FFP | Enormously overrated in treatment of DIC, especially since recent evolution of our understanding and danger of TRALI. Some indication to supplement RBC transfusions in “total body exchange” situations |
| Cryoprecipitate | Probably best source of fibrinogen. Reasonable target is to keep fibrinogen levels between 50 and 100 mg/dL |