Infusion Rates

[Karen Olsen]

I am looking for recommeded infusion rates for Blood Products using an IV pump. Particularly FFP, PLP and Cryo. Does anyone have any suggestions where I might look for this.

I have seen it recently but for the life of me can not remember where and of course now I need it. I am in the process of reviewing our hospital wide transfusion protocol. In other words I need references not just opinions.

Thank you so much in advance for your help!

[Malcolm Needs ☆]

I've looked in all the books I have available to me here at home, and they all say the same thing,

"Transfuse these at a rate that the patient will tolerate."

This strikes me as not a whole lot of use, because, if the patient is unconcious, he or she can hardly say to the doctor/nurse, infusionist,

"Hey, I think my veins are about to rupture!"

Still, that is what it says, so one would assume that, as long as your patient doesn't actually explode, you can put it in as quickly as you want.

Hmmm, think I may have been a bit cynical about the advice available (again).

[BBK710]

The aabb technical manual has recommended infusion rates. In the sixteenth edition it is on p.620 Table21-1.

[Karen Olsen]

Yes, our current policy states " as quickly as the patient can tolerate". That was why I posted this question in the first place- it just doesn't seem fair to Nursing to leave it so vague. If they ask we tell them 30-60 minutes as long as the patient can tolerate that rate. But if they don't ask I imagine they transfuse at the same rate as packed cells. I also would rather give them a rate rather than just an overall time for transfusion.

I do not have the 16th edition. Still on the 15th edition. IT does not give any specifics for the products. Does the 16th edition give a more specific recommendation for products?

Thanks everyone for all your help!

[Malcolm Needs ☆]

Once I crawl out of my sick bed (I have man flu, which my wife describes as a slight head cold - and she is probably quite correct!) I'll ask my Consultant what we use as a maximum transfusion rate in the UK, rather than use the phrase "as quickly as the patient can tolerate".

It does seem more than a little vague, doesn't it!!!!!!!!!!!!!!!!!!!!!!!!!!!!!???????????????

[BBK710]

Suggested Infusion Rates from the 16th addition are:

Adult Pediatric

Red Blood Cells 150-300mL/hr 2-5mL/kg/hr

Fresh Frozen Plasma 200-300mL/hr 60-12ml/hr

Platelets 200-300mL/hr 60-120mL/hr

Cryoprecipitated AHF As rapidly as tolerated As rapidly as tolerated

Granulocytes 75-100mL/hr 65-100mL/hr

They are pretty broad guidelines. We actually tell the nurses 5ml per minute for platelets which usually means that they are running a unit or pool over about an hour. We tell them 10ml per minute for FFP which means it runs about 30 minutes. To be honest I don't remember where we got those guidelines but they are pretty close to the rates from the tech manual.

Edited June 25, 2009 by BBK710
typo

[Karen Olsen]

Thank you BBK710!!

[nancanne]

I got on the thread to read about infusion rates. Instead I am sitting here laughing my head off about the "Man Flu". That's the best I have heard in awhile and so true. My sympathies are all with your wife Malcolm, but thanks for the laugh!!

And the infusion rate data is very helpful. I love this site.

[eric1980]

I still advocate transfusing as fast as the patient can tolerate... Although I understand it may seem difficult to judge on the clinicians' perspective...

[GilTphoto]

Most of our doctors specify how fast they want it infused (transfuse over 3-4 hours for RBC). We recommend 2-3 hours, but there must be a lot of CHF patients as we also see (follow with Lasix). Many doctors are also premedicating with tylenol and Benadryl to aviod febrile and allergic reactions. For FFP we recommend 15-30 minutes. PLT's 30-60 depending on the volume.

You should definately specify that NO blood product should infuse longer than 4 hours, due to the risk of bacterial contamination.