[HSF] aortic root replacement ,svere hyperbilirubinemia

[Edward Bender]

What we get in the OR is one bag of platelets with a volume of about  
200cc.

Ed Bender, MD


On Aug 4, 2007, at 1:33 PM, prasannasimha wrote:

> Are you referring to a single donor plateletpheresis is the norm in  
> all centers. Would not 10-20 such units represent a huge volume ?
>
> Prasanna
>
> Edward Bender wrote:
>> I think that here in the USA, 10 units of platelets is what really  
>> is one bag of single donor platelets.  The same for cryo.
>>
>> Ed Bender, MD
>>
>> On Aug 4, 2007, at 11:46 AM, prasannasimha wrote:
>>
>>> Wow !!
>>> 20 Units of platelets and 10-20 Units of cryo is something that I  
>>> bet would be impossible for many of us to get here . Getting even  
>>> 6 units of platelets is a problem. I usually try to bag out some  
>>> blood and keep it on a Kahn agitator to serve as an autologous  
>>> unit. This seems to work well and there was some paper mentioning  
>>> that this was actually as good as 10 units of stored platelets (I  
>>> think Levee from Israel on this list did that study)
>>> How many units do the others routinely "order" or at least keep  
>>> standby ?
>>> I am curious because we are going to get component processing  
>>> license in our blood bank soon and probably we can process blood.  
>>> Incidentally do any of the members do plateletpheresis of the  
>>> patient prior to surgery ?
>>> Prasanna
>>> Hgrmd at aol.com wrote:
>>>> Prasanna,
>>>>   For a routine Bentall I probably use 2 units FFP, 10-20 units  
>>>> of  cryo, and 20 units of platelets.  If that takes care of the  
>>>> medical  bleeding, we're done.  If bleeding persists, then we  
>>>> give more platelets  and send off stat coags.  The amount of FFP  
>>>> I order depends on how many  units of packed cells have been  
>>>> given since the patient entered the room.   If none, no FFP.  If  
>>>> 2 or more, especially if the patient was on Coumadin  preop, I  
>>>> give 2 units.  I measure the fibrinogen and platelet count  
>>>> during  the pump run.  If fibrinogen less than 200, 10-20 units  
>>>> of cryo.  If  platelet count less than 120K, 10-20 units of  
>>>> platelets.  We still don't  use TEG as yet (I'm in the process  
>>>> of getting it.)  Hopefully, TEG will  help me refine my blood  
>>>> component needs.  I'll never have the low blood  bank  
>>>> utilization that you possess, but I'm working on it.
>>>>  Hal
>>>>
>>>>
>>>>
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