Double Volume Exchange Transfusion Clinical Pathway, ICU – Exchange Volume Passes

Double Volume Exchange Transfusion Clinical Pathway — ICU

Exchange Volume/Passes/Frequency Calculations

Venous-arterial access: infuse donor blood using infusion pump through venous line
Venous access only: use push-pull method (no infusion pump needed)

Calculation Worksheet for bedside use.

Definition Calculation Example
Weight = 3 kg
Total Volume of Blood to Exchange
90 mL/kg x weight in kg x 2
> 1 mo old use 70 ml/kg instead of 90 ml/kg		 90 mL x 3kg x 2 = 540 mL
Length of Each Pass
Amount of time that blood will be withdrawn
 3 mins/pass 3 mins/pass
Volume of Each Pass 2 mL/kg/min × weight × pass length 2 mL × 3 kg × 3 = 18 mL
Amount withdrawn over 3 mins
Pump Rate
(Venous-arterial access only)
Rate at which nursing will program the infusion pump in mL/hour
 2 mL/kg/min × weight × 60 2 mL × 3 kg × 60 min = 360 mL/hr
Volume to be Infused (VTBI) Total volume entered into "VTBI" part of
Alaris infusion pump by RN at start of each pass		 18 mL
Amount infused over 3 mins
Length of Procedure Total blood volume/pump rate 540/360 = 1.5 hrs (90 mins)