Dosage and timing

• A single dose of platelets is generally supplied as a single bag.

• Represents a standard transfusion dose although twice this amount may be required to cover insertions of central lines or minor surgery.

• Occasionally double doses may be required for patients becoming refractory.

• The frequency of platelet transfusion will be determined by clinical circumstances. In general, a patient who is well, afebrile and with no evidence of new bruising or bleeding need only have a platelet count maintained above 10 x 109/L. May be achieved with platelets given as infrequently as every 2-4 days with this estimate being guided on daily platelet counts.

• Patients who are infected or bleeding have much greater platelet requirements—aim to keep the platelet count >20 x 109/L. This will usually mean daily platelet infusions for the duration of this clinical episode.

• Platelet counts of <10 x 109/L should always be avoided but within these constraints the fewer platelets transfused the better since this

546 reduces the risk of alloimmunisation to HLA and platelet antigens.

• Anyone with a persistent platelet count <10 x 109/L should be started on tranexamic acid 1g qds PO or IV unless specific contraindications exist such as genitourinary tract bleeding.

0 0

Post a comment