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Patients with Sickle Cell Disease
PAWHITTECAR replied to rravkin@aol.com's topic in Transfusion Services
I too work at two different facilities, one a children's hospital, where we do a full phenotype on all are sickle patients. We give Rh and K matched units with the exception of little e which we only give if the antibody is present. If the patient presents to us without being a candidate to phenotype(transfused in the last 3 months) we will give C, E and K neg units until we can get a isotonic saline wash phenotype completed. Also we follow this protocal on an emergent basis if there is not a phenotype available. This way we do not have to delay transfusion waiting on the phenotype. We do always try to do the Rh's and K prior to transfusion is time permits. -
I'm not sure if you have gotten the information you need but our facility does ECMO (often) on all size patients. We have had babies that weighed < a kilogram up to the 35 yr old man that was 6'2" and weighed 265 lbs. We currently have monitered refrigerators in all the units that do ECMO but before those were in place we sent a bedside blood box with the initial red cell units and then maintained it at the bedside with 1-2 maintenance units in case of emergency (membrane rupture or accidental decanulation). We moitered the temp and changed the ice every eight hours. As to how much blood is needed to prime the circuit it depends again on the patient's size for adults they generally use 3-4 units and they generally give 1 platelet pheresis.
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There is a drug givin to increase platelet production that is called WinRho. Tis will cause an anti-D in patients taking it.