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
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Platelet: no recommended guidelines | Platelet:• 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
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Plasma: no recommended guidelines | Plasma:• 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
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Cryoprecipitate: no recommended guidelines | Cryoprecipitate:• 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
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