輸血醫學---臨床輸血實務 lecture/pediatrics/王士忠醫師... ·...
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(When) (What) (How)
1. (When)------
2. (What)---3. (How)-----
4.
In Taiwan:
:250 mL
250ml
:17 65
17
65
45kg50kg
50kg
37.5 (99.6)
90/160mmHg 50/95mmHg 3090mmHg
:13g/dL(1.054)12g/dL(1.052)
:150x103
:3000/mm3
:
6g/L
250ml60kg500ml
250ml500ml1500ml1000ml
500ml12L
()
B()
72Aspirin
C
T(HTLV-1)
AIDS
AIDSAIDS
(HIV-I/HIV-II)
(CJD) (CJD)
ABORh
B(HBsAg)
(ALT)
(anti-HIV-1/2)
C (anti-HCV)
T (anti-HTLV-I/II)
1. (When)------
2. (What)---3. (How)-----
4.
1. (When)------
2. (What)---3. (How)-----
4.
RBC()Whole blood()PRBC()WRBC()LPRBC(Leukocyte-poor RBC)( )Frozen, Thawed Deglycerolized Red Blood Cells ()
Platelet ()Platelet Concentrate ( )Apheresis platelet ()Prestorage Lukocyte-Reduced ApheresisPlatelet ()
Plasma()Fresh Frozen Plasma, FFP ()Frozen Plasma ()Cryoprecipitate ()
WBC()White blood Cells Concentrate ()Apheresis Leukocyte ()
Blood component therapy
36~40%
,
-(Leukocyte poor RBC)
1. (When)------
2. (What)---3. (How)-----
4.
---1 UWhole blood: 250mLPRBC, WRBC,LPRBC: 150mLFFP,FP:150mLPlatelet concentrate:30mLApheresis platelet:300-360mL(10-12U Platelet concentrate)Cryoprecipitate:15-20mL
(Filter)(99%)---
(Iiradiation)---GVHD(Graft-versus-Host Disease)
(250mL)35mLCPDA-1285mL100mL150mL32~42%2475%2,3-DPG
30%2~4
(250mL)Hb0.5g/dL; Hct1-2%2~38~10mL
(microaggregates)()
170Y22234
(250mL)4
30
(50mL/kg/hr)
(15mL/kg/hr)
37
5
1~6
35(
250mL500mL
Packed RBC
Hct70~80% 24
250mL500mL35mL70mLCPDA-1 250mL150mL 100mL 40mL 40
Packed RBC
10~15mL/Kg1mL/KgPRBC Hct1%
Packed RBC
(GVHD)
Packed RBC
B12
Packed RBC: 1~6
: 35 ()
:
250mL118~192mL1
500mL238~386mL2
(Washed Red Blood Cells)0.9%
(Washed Red Blood Cells)
Hct75%2480%
(Washed Red Blood Cells)
25108
(Paroxysmal Nocturnal Hemoglobinuria, PNH)IgA
(Washed Red Blood Cells)
10~15mL/Kg1mL/KgPRBC Hct1%
24
(Washed Red Blood Cells)1~6
24
2200~350ml2
(Leukocyte-poor Red Blood Cells)
2SAGMCPDA-1Filter
Leukocyte-Reduced RBCsLeukocyte-depleted RBCs
(Leukocyte-poor Red Blood Cells)
HLA
Hct52~60% 24
(Leukocyte-poor Red Blood Cells)
2SAGMFilter
5106
(Leukocyte-poor Red Blood Cells)
(Leukocyte-poor Red Blood Cells)
24
Bilirubin
(Leukocyte-poor Red Blood Cells)
1~6
24
2SAGM200~350 ml2
( Frozen, Thawed Deglycerolized Red Blood Cells)
( Frozen, Thawed Deglycerolized Red Blood Cells)
99
Hct75%
( Frozen, Thawed Deglycerolized Red Blood Cells)
2
-65-15010ATP2,3-DPG
( Frozen, Thawed Deglycerolized Red Blood Cells)
( Frozen, Thawed Deglycerolized Red Blood Cells)
1~6
24
2200~350 ml2
(Platelet Concentrate)
250 ml30~40 ml
PRP-PC
2~3101030~40 ml
(Platelet Concentrate)
50,000/l
a. b. c. d. 10,000~20,000/l
a. 50,000/lb. 100,000/l10,000~20,000/l
(Platelet Concentrate)
10~1210210~15mL/Kg
(Platelet Concentrate)
170-YABO
(Platelet Concentrate)(Corrected Count Increment: CCI )7,500CCI=(-)(/L)x(m2)
(x1011)
(Platelet Concentrate)CCI
ABO
DICactive infectionHLA
(Immune Thrombocytopenic Purpura; ITP)
(Platelet Concentrate)
20~24
5
250 ml30~40 ml1
500 ml60~80 ml2
(Apheresis platelet)
200~300 ml
Single-donor Platelet
(Apheresis platelet)
HLAHLAHLAHLAHLA
(Apheresis platelet)
31011200~300 ml12
(Apheresis platelet)
HLA
HLAHLA
20,000/l
(Apheresis platelet)
HLA
HLA
(Apheresis platelet)
20~24
5
200~300 ml
Prestorage Lukocyte-Reduced Apheresis Platelets
Prestorage Leukocyte Reduced Apheresis Platelets
cytokinealloimmunizationCMV
Prestorage Lukocyte-Reduced Apheresis Platelets
3101195510690PH6.2
1.
2.HLA
3.CMV
Prestorage Lukocyte-Reduced Apheresis Platelets
24(CCI)
(Fresh Frozen Plasma, FFP)
8VVIII
-18
(Fresh Frozen Plasma, FFP)
250 ml90~120 mlVVIII
(Fresh Frozen Plasma, FFP)
DIC
PT
IIV VIIXXIXIII
(Fresh Frozen Plasma, FFP)
10~15mL/KgPTPTT
(Fresh Frozen Plasma, FFP)
30~372 42424VVIII
(Fresh Frozen Plasma, FFP)
ABO
Albumin
(Fresh Frozen Plasma, FFP)20
250 ml90 ml1
500 ml200 ml2
(Frozen Plasma)
81~6
stored frozen plasmacryo-reduced plsmaCryo
(Frozen Plasma)
100~150 ml90Factor VVIII
(Frozen Plasma)
II15ml/kg10ml/kg
VII10ml/kg5ml/kg
XI30ml/kg127ml/kg60ml/kg
X15ml/kg10ml/kg
200~400 ml800ml
(Frozen Plasma)
30~374
(Frozen Plasma)20
250 ml90 ml1
500 ml200 ml2
(Cryoprecipitate)
6-801~6
cryoprecipitated AHF, cryo
(Cryoprecipitate)
1~615~20 ml-80
45125mg40~70von-Willebrand20~30
(Cryoprecipitate)
A
Von-Willebrand
(Cryoprecipitate)
1U/2Kg (0.5U/Kg)
30~371~6
1~62
0.9%
(Cryoprecipitate)
ABO
20
250 ml10~15 ml1
500 ml25~30 ml2
/
/
Summary1.
---2.
---3.
---1 U; 4.