Blood Transfusion of PRBC during dialysis

[nursedandy]

I cannot get a concrete answer to this. Does the patient potassium increases with blood transfusion? Is it necessary to connect the end of BT line to the arterial chamber so it passes to the dialyzer or it doesnt matter? Pls. share your experiences:uhoh3:

[KellyCCRN]

Yes K+ can increase with transfusion of PRBC....the is aproximately 7meq K+ per unit of blood but that varies according to the "freshness" of the PRBC. We typically adjust the dialysate bath if a pt is to receive more than 1 unit PRBC's say for instance the pt's K+ is 4.2 we would run them on a 2K+ bath instead of our standard protocol for a 3K+ bath to prevent hyperkalemia.

[siew eng]

We connect the blood transfusion line to the arterial line just before the blood pump but not at the arterial trap/chamber. That means the blood actually do passes to the dialyser and I would say that the excess potassium in the blood will get diffused off better as the concentration gradient would be higher as blood is being transfused during dialysis.

Can anyone share with me the duration of blood transfusion during dialysis for 1 or 2 units of blood? Any documentation or guidelines I can refer to?

Siew Eng

[Gmac]

We are doing BT during HD as fast as 15 mins for each bag ( 250-300 mL) So it's possible that you can finish it for 30 mins. But I'm doing only 30 mins. for each bag.

[Tish88]

Yes, K+ does increase, but slightly. I start my transfusions at the beginning of the treatment to adjust the pt's K+ during their treatment. I run them on their regularly ordered K+ bath, since it will normalize during the treatment.

I transfuse each unit over 30 minutes to prevent any fluid overload. Make sure you adjust your UF for each of the unit given. With giving it at the beginning of the treatment, this allows you to take off the extra fluid over the longer period of time. Each unit is 300cc.

You would need to run it through your arterial portion, since you will need to use the pump on the machine. You can't infuse PRBC's into the venous drip chamber without a IV pump.

I don't use a IV pump when connecting to the arterial portion. I just eyeball my drip rate.

[nlhrn]

As stated above it must go into the arterial chamber for the "pull" and so it can go throught the dialyzer to remove the extra k+,,we do not adjust the bath at all.