Single unit transfusion refers to transfusing a single unit or bag of blood product to a person who is not bleeding and haemodynamically stable followed by an assessment to see if further transfusion is required..
The benefits of single unit transfusion include reduced exposure to blood products. Each unit transfused increases the associated risks of transfusion such as infection,
transfusion associated circulatory overload and other side effects. Transfusion of a single unit also encourages less wastage of blood products and can be cost-effective. Single unit transfusion can be as part of an institutional or national guidelines
and instituted with the help of a transfusion committee or
transfusion practitioner. Education of medical staff is important and catch phrases such as "Why use two when one will do", "every ONE matters" or "one bag is best - then reassess" have been used.
Red blood cells
Following one bag of
red blood cells
Red blood cells (RBCs), referred to as erythrocytes (, with -''cyte'' translated as 'cell' in modern usage) in academia and medical publishing, also known as red cells, erythroid cells, and rarely haematids, are the most common type of blood cel ...
, symptom relief is assessed in terms of shortness of breath, chest pain and tiredness. A post transfusion full blood count could be undertaken to assess for the rise in hemoglobin.
Plasma
Transfusion of
fresh frozen plasma
Fresh frozen plasma (FFP) is a blood product made from the liquid portion of whole blood. It is used to treat conditions in which there are low blood clotting factors (INR > 1.5) or low levels of other blood proteins. It may also be used as the r ...
aims to replace of
clotting factors
Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The process of coagulatio ...
. Single unit transfusion also applies to transfusion of fresh frozen plasma in that there should be a clinical indication for the number transfused.
Coagulation studies and point of care whole blood functional assays such as TEG or ROTEM can be used to assess whether further units are required.
Platelets
The single unit policy is helpful in platelet
transfusion as there this blood component has a short shelf-life than other components. Assessment after one bag can include assessing clinical bleeding, platelet count looking at the post transfusion increment and/or functional platelet assessments.
References
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Blood