Double Volume Exchange Transfusion Clinical Pathway, ICU – Order Blood Products

Double Volume Exchange Transfusion Clinical Pathway — ICU

Order Blood Products

Preparing for Blood Products

  • Send type and screen and blood type confirmation if not already sent
  • Order the blood products STAT
  • Anticipate 2-4 hrs for blood availability
  • Call Blood Bank x42527 with the following information:
    • Birth hospital
    • Maternal blood type/antibodies
    • Previous transfusions prior to CHOP admission
  • Blood bank will call ordering provider to confirm proceeding with exchange prior to final reconstitution of red cells

Preparing for Blood Products

Utilize the exchange transfusion order set to order the reconstituted blood. Blood bank will reconstitute with fresh frozen plasma (FFP) to the hematocrit specified in the order.

For DVET for hyperbilirubinemia, a hematocrit of 40% should be selected in the order.

How to Calculate the Volume of Blood to Order
  • Estimated blood volume (EBV)
    • Infants < 1 mo, use an EBV of 90 mL/kg
    • Infants ≥ 1 mo, use an EBV of 70 mL/kg
  • Volume to Exchange
    Volume of blood needed for an exchange transfusion based on weight
  • Step 1
    EBV × (weight in kg) × 2
  • Reconstituted Whole Blood Order
    Volume of PRBCs to order for exchange transfusion
  • Step 2
    Amount from Step 1 + 50 mL
    Used for priming blood warmer
  • Example: Weight = 3 kg
  • Infants < 1 mo
    90 mL × 3 × 2 = 540 mL (volume to exchange) + 50 mL (priming) = 590 mL (reconstituted whole blood to order)
  • Infants ≥ 1 mo
    70 mL × 3 × 2 = 420 mL (volume to exchange) + 50 mL (priming) = 470 mL (reconstituted whole blood to order)