For a step by step guide, please refer to our downloadable document at the bottom of this page
If time allows, all blood products should be warmed gently to room temperature. If preferred, products can be warmed to body temperature (37°C) using a warm water bath. Water must be monitored using a thermometer as it must stay below 37°C. Alternatively, you can use a commercial water bath. The product should be protected in a plastic zip lock bag to prevent contamination of the ports.
Products containing red cells should be given through a filter to facilitate removal of any small clots and other debris that may be present. These filters can be an integral part of the blood administration set or attached to the extension line (filters are available to order from us) if delivering the red cell transfusion from a syringe via an intravenous extension set (common with small dogs). Peristaltic type infusion pumps are not recommended for the administration of red cell containing products unless the manufacturer has specifically stated they are safe to do so. We recommend a new administration set or filter and extension set is used for each new unit of red cells.
With stable patients, an initial infusion rate of 0.5-1.0 ml/kg/hr should be used for the first 15-30 minutes. During this time the patient should be monitored for any evidence of a transfusion reaction. If no reaction is seen, this can be increased to a standard rate of 5-10ml/kg/hr. Any red cells remaining in the bag or syringe 4 hours after breach or withdrawal into a syringe (and remaining at room temperature) must be discarded. Blood units can be separated into smaller volumes if the time over which they are to be given will exceed 4 hours (see blood component separation guidance). In an emergency (e.g. severe acute haemorrhage), red cells can be given at up to shock rates. Slower rates of 1-2ml/kg/hr are recommended for patients with circulatory compromise.
Pet Blood Bank recommends checking with the manufacturer regarding the suitability of any infusion pump to deliver red cell products prior to its use. This is because delivery via a mechanical system may be associated with a high risk of premature transfused red cell loss in dogs (McDevitt et al, 2011).
In the past, packed red blood cells required re-suspension with 0.9% NaCl as their PCV was so high that they could not be infused alone. However, as packed red cell products today typically have had a red cell extender (nutrient solution) added, this is less of a problem and resuspension with saline is rarely necessary. Calcium containing fluids such as Hartmann’s solution must always be administered separately from blood products.
Blood typing prior to administration should be standard procedure and cross matching will be required if a transfusion has been given more than four days previously and prior to every subsequent transfusion.
Our transfusion monitoring record can be found at the bottom of this page. We recommend you print and use this during the transfusion.
To calculate the amount of red cells needed, please see our canine transfusion calculator.