Table 1.

Comparison of 2008 and 2012 FMH guidelines

20082012
Red blood cells:
  • Regardless of the patient’s hemoglobin value in a patient with normovolemia and symptomatic anemia

  • Patient with acute blood loss of >15% of estimated blood volume

  • Patient with acute blood loss with evidence of adequate oxygen delivery

  • Preoperative hemoglobin 8 g/dL and operative procedure associated with major blood loss

  • Hemoglobin <8 g/dL in a patient on a long-term transfusion regimen

Red blood cells:
  • Hematocrit ≤21% or hemoglobin ≤7 g/dL in a patient with no known cardio-respiratory disease

  • Hematocrit ≤25% or hemoglobin ≤8 g/dL in a patient with cardiac, cerebral, or other major organ ischemia or hypoproliferative anemia

  • Rapid blood loss with >20% not responding to appropriate volume resuscitation, or with ongoing blood loss

Platelet: no recommended guidelinesPlatelet:
  • Platelet count ≤10 000/µL prophylactically in a patient with failure of platelet production

  • Platelet count ≤20 000/µL and signs of hemorrhagic diathesis (petechiae, mucosal bleeding)

  • Platelet count ≤50 000/µL in a bleeding patient or a patient undergoing an invasive procedure

  • Active hemorrhage

  • Platelet dysfunction as documented by platelet function test result(s) or medication known to cause platelet dysfunction

Plasma: no recommended guidelinesPlasma:
  • Active bleeding or a patient undergoing an invasive procedure with an INR >1.6 or APTT >40s

  • Plasma exchange for TTP or HUS

  • Emergency reversal of warfarin

Cryoprecipitate: no recommended guidelinesCryoprecipitate:
  • Fibrinogen ≤100 mg/dL

  • Renal failure with an abnormal closure time (platelet function test) and one of the following: active hemorrhage, operation, or invasive procedure within 24 h

  • Von Willebrand disease if DDAVP or Humate-P (or comparable factor concentrate) is not available