{"id":398,"date":"2019-04-05T08:45:04","date_gmt":"2019-04-05T11:45:04","guid":{"rendered":"https:\/\/preservasangue.com.br\/?page_id=398"},"modified":"2022-07-25T12:35:49","modified_gmt":"2022-07-25T15:35:49","slug":"quando-transfundir","status":"publish","type":"page","link":"https:\/\/educasangue.com.br\/index.php\/quando-transfundir\/","title":{"rendered":"Quando transfundir"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"398\" class=\"elementor elementor-398\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-755cfaf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"755cfaf\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ed8bad4\" data-id=\"ed8bad4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-4eb5d7a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4eb5d7a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-815ed84\" data-id=\"815ed84\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-587cc32\" data-id=\"587cc32\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9fb1cc8 elementor-widget elementor-widget-elementskit-social-media\" data-id=\"9fb1cc8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-social-media.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" >\t\t\t <ul class=\"ekit_social_media\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<li class=\"elementor-repeater-item-5eb0945\">\n\t\t\t\t\t    <a\n\t\t\t\t\t\thref=\"https:\/\/m.facebook.com\/educasangue1\" aria-label=\"Facebook\" class=\"facebook\" >\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"icon icon-facebook\"><\/i>\n                                                                                                            <\/a>\n                    <\/li>\n                    \t\t\t\t\t\t\t\t\t\t\t\t\t\t<li class=\"elementor-repeater-item-e2aa959\">\n\t\t\t\t\t    <a\n\t\t\t\t\t\thref=\"https:\/\/www.instagram.com\/educasangue\/?hl=pt-br\" aria-label=\"Instagram\" class=\"instagram\" >\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fab fa-instagram\"><\/i>\n                                                                                                            <\/a>\n                    <\/li>\n                    \t\t\t\t\t\t\t<\/ul>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-22a5f10 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"22a5f10\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0d94b04\" data-id=\"0d94b04\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-88809b4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"88809b4\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-ca39cc9\" data-id=\"ca39cc9\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-60fa084 elementor-widget elementor-widget-image\" data-id=\"60fa084\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"525\" height=\"164\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/09\/EducaSangue.png\" class=\"attachment-large size-large wp-image-3917\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-7a00a3a\" data-id=\"7a00a3a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c5661fb elementor-hidden-tablet elementor-hidden-phone elementor-widget elementor-widget-ekit-nav-menu\" data-id=\"c5661fb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"ekit-nav-menu.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<nav class=\"ekit-wid-con ekit_menu_responsive_tablet\"\n\t\t\tdata-hamburger-icon=\"\"\n\t\t\tdata-hamburger-icon-type=\"icon\"\n\t\t\tdata-responsive-breakpoint=\"1024\">\n\t\t\t            <button class=\"elementskit-menu-hamburger elementskit-menu-toggler\"  type=\"button\" aria-label=\"hamburger-icon\">\n                                    <span class=\"elementskit-menu-hamburger-icon\"><\/span><span class=\"elementskit-menu-hamburger-icon\"><\/span><span class=\"elementskit-menu-hamburger-icon\"><\/span>\n                            <\/button>\n            <div id=\"ekit-megamenu-principal\" class=\"elementskit-menu-container elementskit-menu-offcanvas-elements elementskit-navbar-nav-default ekit-nav-menu-one-page-no ekit-nav-dropdown-hover\"><ul id=\"menu-principal\" class=\"elementskit-navbar-nav elementskit-menu-po-center submenu-click-on-icon\"><li id=\"menu-item-2648\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-home menu-item-2648 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/\" class=\"ekit-menu-nav-link\">Home<\/a><\/li>\n<li id=\"menu-item-4049\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4049 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/sobre\/\" class=\"ekit-menu-nav-link\">sobre<\/a><\/li>\n<li id=\"menu-item-3155\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-home menu-item-has-children menu-item-3155 nav-item elementskit-dropdown-has relative_position elementskit-dropdown-menu-default_width elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/\" class=\"ekit-menu-nav-link ekit-menu-dropdown-toggle\">PBM<i aria-hidden=\"true\" class=\"icon icon-down-arrow1 elementskit-submenu-indicator\"><\/i><\/a>\n<ul class=\"elementskit-dropdown elementskit-submenu-panel\">\n\t<li id=\"menu-item-1207\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1207 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/o-que-e-pbm\/\" class=\" dropdown-item\">O que \u00e9 PBM?<\/a>\t<li id=\"menu-item-167\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-167 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/pbm-no-ceara\/\" class=\" dropdown-item\">PBM no Cear\u00e1<\/a><\/ul>\n<\/li>\n<li id=\"menu-item-3464\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-3464 nav-item elementskit-dropdown-has relative_position elementskit-dropdown-menu-default_width elementskit-mobile-builder-content\" data-vertical-menu=750px><a class=\"ekit-menu-nav-link ekit-menu-dropdown-toggle\">Transfus\u00e3o<i aria-hidden=\"true\" class=\"icon icon-down-arrow1 elementskit-submenu-indicator\"><\/i><\/a>\n<ul class=\"elementskit-dropdown elementskit-submenu-panel\">\n\t<li id=\"menu-item-3636\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3636 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/quando-transfundir\/\" class=\" dropdown-item\">Quando transfundir<\/a>\t<li id=\"menu-item-3637\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3637 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/como-evitar-a-transfusao-desnecessaria\/\" class=\" dropdown-item\">Como evitar a transfus\u00e3o desnecess\u00e1ria<\/a>\t<li id=\"menu-item-3638\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3638 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/procedimento-de-transfusao\/\" class=\" dropdown-item\">Procedimento de transfus\u00e3o<\/a>\t<li id=\"menu-item-3639\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3639 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/suspeita-de-reacao-transfusional\/\" class=\" dropdown-item\">Suspeita de rea\u00e7\u00e3o transfusional<\/a>\t<li id=\"menu-item-3659\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-3659 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/plasma\/\" class=\" dropdown-item\">Testes pr\u00e9-transfusionais<\/a><\/ul>\n<\/li>\n<li id=\"menu-item-3346\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3346 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/dicas-e-videos-2\/\" class=\"ekit-menu-nav-link\">Dicas<\/a><\/li>\n<li id=\"menu-item-3631\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-3631 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/biblioteca\/\" class=\"ekit-menu-nav-link\">Evid\u00eancias<\/a><\/li>\n<li id=\"menu-item-3630\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-3630 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/download\/\" class=\"ekit-menu-nav-link\">Download<\/a><\/li>\n<li id=\"menu-item-162\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-162 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/fale-conosco\/\" class=\"ekit-menu-nav-link\">Fale conosco<\/a><\/li>\n<\/ul><div class=\"elementskit-nav-identity-panel\"><a class=\"elementskit-nav-logo\" href=\"https:\/\/educasangue.com.br\" target=\"\" rel=\"\"><img src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/11\/placeholder.png\" title=\"\" alt=\"\" decoding=\"async\" \/><\/a><button class=\"elementskit-menu-close elementskit-menu-toggler\" type=\"button\">X<\/button><\/div><\/div>\n\t\t\t<div class=\"elementskit-menu-overlay elementskit-menu-offcanvas-elements elementskit-menu-toggler ekit-nav-menu--overlay\"><\/div>        <\/nav>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-85968c7 elementor-hidden-desktop elementor-widget elementor-widget-ekit-nav-menu\" data-id=\"85968c7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"ekit-nav-menu.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<nav class=\"ekit-wid-con ekit_menu_responsive_mobile\"\n\t\t\tdata-hamburger-icon=\"icon icon-menu-button-of-three-horizontal-lines\"\n\t\t\tdata-hamburger-icon-type=\"icon\"\n\t\t\tdata-responsive-breakpoint=\"767\">\n\t\t\t            <button class=\"elementskit-menu-hamburger elementskit-menu-toggler\"  type=\"button\" aria-label=\"hamburger-icon\">\n                <i aria-hidden=\"true\" class=\"ekit-menu-icon icon icon-menu-button-of-three-horizontal-lines\"><\/i>            <\/button>\n            <div id=\"ekit-megamenu-menu_mobile\" class=\"elementskit-menu-container elementskit-menu-offcanvas-elements elementskit-navbar-nav-default ekit-nav-menu-one-page- ekit-nav-dropdown-hover\"><ul id=\"menu-menu_mobile\" class=\"elementskit-navbar-nav elementskit-menu-po-left submenu-click-on-icon\"><li id=\"menu-item-3919\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-home menu-item-3919 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/\" class=\"ekit-menu-nav-link\">Home<\/a><\/li>\n<li id=\"menu-item-4048\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4048 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/sobre\/\" class=\"ekit-menu-nav-link\">sobre<\/a><\/li>\n<li id=\"menu-item-3921\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-home menu-item-has-children menu-item-3921 nav-item elementskit-dropdown-has relative_position elementskit-dropdown-menu-default_width elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/\" class=\"ekit-menu-nav-link ekit-menu-dropdown-toggle\">PBM<i aria-hidden=\"true\" class=\"icon icon-down-arrow1 elementskit-submenu-indicator\"><\/i><\/a>\n<ul class=\"elementskit-dropdown elementskit-submenu-panel\">\n\t<li id=\"menu-item-3922\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3922 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/o-que-e-pbm\/\" class=\" dropdown-item\">O que \u00e9 PBM?<\/a>\t<li id=\"menu-item-3923\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3923 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/pbm-no-ceara\/\" class=\" dropdown-item\">PBM no Cear\u00e1<\/a><\/ul>\n<\/li>\n<li id=\"menu-item-3942\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-home menu-item-has-children menu-item-3942 nav-item elementskit-dropdown-has relative_position elementskit-dropdown-menu-default_width elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/\" class=\"ekit-menu-nav-link ekit-menu-dropdown-toggle\">Transfus\u00e3o<i aria-hidden=\"true\" class=\"icon icon-down-arrow1 elementskit-submenu-indicator\"><\/i><\/a>\n<ul class=\"elementskit-dropdown elementskit-submenu-panel\">\n\t<li id=\"menu-item-3929\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3929 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/quando-transfundir\/\" class=\" dropdown-item\">Quando transfundir<\/a>\t<li id=\"menu-item-3931\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3931 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/plasma\/\" class=\" dropdown-item\">testes pr\u00e9 transfusionais<\/a>\t<li id=\"menu-item-3928\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3928 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/procedimento-de-transfusao\/\" class=\" dropdown-item\">Procedimento de transfus\u00e3o<\/a>\t<li id=\"menu-item-3930\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3930 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/suspeita-de-reacao-transfusional\/\" class=\" dropdown-item\">Suspeita de rea\u00e7\u00e3o transfusional<\/a>\t<li id=\"menu-item-3927\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3927 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/como-evitar-a-transfusao-desnecessaria\/\" class=\" dropdown-item\">Como evitar a transfus\u00e3o desnecess\u00e1ria<\/a><\/ul>\n<\/li>\n<li id=\"menu-item-3925\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3925 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/dicas-e-videos-2\/\" class=\"ekit-menu-nav-link\">Dicas<\/a><\/li>\n<li id=\"menu-item-3932\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3932 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/biblioteca\/\" class=\"ekit-menu-nav-link\">Evid\u00eancias<\/a><\/li>\n<li id=\"menu-item-3933\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3933 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/download\/\" class=\"ekit-menu-nav-link\">Download<\/a><\/li>\n<li id=\"menu-item-3934\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3934 nav-item elementskit-mobile-builder-content\" data-vertical-menu=750px><a href=\"https:\/\/educasangue.com.br\/index.php\/fale-conosco\/\" class=\"ekit-menu-nav-link\">Fale conosco<\/a><\/li>\n<\/ul><div class=\"elementskit-nav-identity-panel\"><a class=\"elementskit-nav-logo\" href=\"https:\/\/educasangue.com.br\" target=\"\" rel=\"\"><img src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/09\/EducaSangue.png\" title=\"EducaSangue\" alt=\"EducaSangue\" decoding=\"async\" \/><\/a><button class=\"elementskit-menu-close elementskit-menu-toggler\" type=\"button\">X<\/button><\/div><\/div>\n\t\t\t<div class=\"elementskit-menu-overlay elementskit-menu-offcanvas-elements elementskit-menu-toggler ekit-nav-menu--overlay\"><\/div>        <\/nav>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-5aaa103\" data-id=\"5aaa103\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2f784fe elementor-widget elementor-widget-elementskit-header-search\" data-id=\"2f784fe\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-header-search.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" >        <a href=\"#ekit_modal-popup-2f784fe\" class=\"ekit_navsearch-button ekit-modal-popup\" aria-label=\"navsearch-button\">\n            <i aria-hidden=\"true\" class=\"icon icon-search\"><\/i>        <\/a>\n        <!-- language switcher strart -->\n        <!-- xs modal -->\n        <div class=\"zoom-anim-dialog mfp-hide ekit_modal-searchPanel\" id=\"ekit_modal-popup-2f784fe\">\n            <div class=\"ekit-search-panel\">\n            <!-- Polylang search - thanks to Alain Melsens -->\n                <form role=\"search\" method=\"get\" class=\"ekit-search-group\" action=\"https:\/\/educasangue.com.br\/\">\n                    <input type=\"search\" class=\"ekit_search-field\" aria-label=\"search-form\" placeholder=\"Pesquisar\" value=\"\" name=\"s\">\n\t\t\t\t\t<button type=\"submit\" class=\"ekit_search-button\" aria-label=\"search-button\">\n                        <i aria-hidden=\"true\" class=\"icon icon-search\"><\/i>                    <\/button>\n                <\/form>\n            <\/div>\n        <\/div><!-- End xs modal -->\n        <!-- end language switcher strart -->\n        <\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-0d8bfef\" data-id=\"0d8bfef\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-48dd4dc elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"48dd4dc\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-69f81cd\" data-id=\"69f81cd\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8ae1a36 elementor-widget elementor-widget-heading\" data-id=\"8ae1a36\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-large\">indica\u00e7\u00e3o de<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e1699cf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e1699cf\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f129900\" data-id=\"f129900\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-57544a8 elementor-widget elementor-widget-heading\" data-id=\"57544a8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">TRANSFUS\u00c3O<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7fe4fdb elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"7fe4fdb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e7658c4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e7658c4\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-42371c5\" data-id=\"42371c5\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-2c22731 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2c22731\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-9bb7cde\" data-id=\"9bb7cde\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-26c583c elementor-widget elementor-widget-text-editor\" data-id=\"26c583c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h6><strong>Bem vindo ao nosso espa\u00e7o dedicado a discutir com voc\u00ea a indica\u00e7\u00e3o dos hemocomponentes de acordo com evid\u00eancias cl\u00ednicas!<\/strong><\/h6><p>A transfus\u00e3o \u00e9 importante e necess\u00e1ria para a pr\u00e1tica da medicina atual e o <strong>sangue transfundido nunca foi<\/strong> <b>t\u00e3o seguro!\u00a0<\/b> Mas lembre que transfus\u00e3o aumenta complica\u00e7\u00f5es e pode comprometer a evolu\u00e7\u00e3o do paciente. O risco de eventos adversos imediatos e tardios relacionados \u00e0 transfus\u00e3o \u00e9 de 1 a 3%, apesar de toda a tecnologia envolvida na triagem de doadores volunt\u00e1rios de sangue.<\/p><p><strong>N\u00e3o existe transfus\u00e3o totalmente segura<\/strong>\u00a0<strong>e sua indica\u00e7\u00e3o deve buscar maior benef\u00edcio e menor risco para o paciente. Evite transfus\u00f5es desnecess\u00e1rias. A melhor transfus\u00e3o \u00e9 aquela que n\u00e3o acontece.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-5a757dd\" data-id=\"5a757dd\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2b73651 elementor-widget elementor-widget-toggle\" data-id=\"2b73651\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-4551\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-4551\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Reflita antes de prescrever a transfus\u00e3o (OMS)<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-4551\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-4551\"><p>1. Qual a melhora na condi\u00e7\u00e3o cl\u00ednica do paciente que estou esperando?<br>2. Posso minimizar a perda sangu\u00ednea para reduzir a necessidade transfusional do paciente?<br>3. H\u00e1 outros tratamentos que devo realizar antes de transfundir, tais como reposi\u00e7\u00e3o de fluidos intravenosos ou oxig\u00eanio?<br>4. H\u00e1 indica\u00e7\u00f5es espec\u00edficas cl\u00ednicas ou laboratoriais para transfundir este paciente?<br>5. Quais os riscos de transmitir HIV, hepatite, s\u00edfilis ou outros agentes infecciosos atrav\u00e9s dos produtos sangu\u00edneos dispon\u00edveis para este paciente?<br>6. Os benef\u00edcios da transfus\u00e3o superam os riscos neste paciente em particular?<br>7. Quais as outras op\u00e7\u00f5es se o sangue n\u00e3o estiver dispon\u00edvel neste momento?<br>8. Uma pessoa treinada monitorar\u00e1 este paciente e responder\u00e1 imediatamente se o mesmo apresentar alguma rea\u00e7\u00e3o transfusional aguda?<br>9. Registrei minha decis\u00e3o e as raz\u00f5es da transfus\u00e3o no prontu\u00e1rio do paciente e no formul\u00e1rio de requisi\u00e7\u00e3o de sangue?<br>10. Finalmente, se estiver em d\u00favida, pergunte a si mesmo: se o sangue fosse para mim ou para meu filho, eu aceitaria a transfus\u00e3o nestas circunst\u00e2ncias?<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-0ee5882 elementor-widget elementor-widget-text-editor\" data-id=\"0ee5882\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>\u00c9 importante saber!\u00a0<\/strong>A indica\u00e7\u00e3o e a prescri\u00e7\u00e3o da transfus\u00e3o s\u00e3o exclusivas do m\u00e9dico. A transfus\u00e3o s\u00f3 pode ocorrer em local em que haja pelo menos um m\u00e9dico apto e dispon\u00edvel para manusear poss\u00edveis intercorr\u00eancias. A indica\u00e7\u00e3o da transfus\u00e3o pode ser objeto de an\u00e1lise do m\u00e9dico do servi\u00e7o de hemoterapia.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b7ad0d8 elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"b7ad0d8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-burn\"><\/i><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5a26c5f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5a26c5f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0113652\" data-id=\"0113652\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-a0145bf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a0145bf\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-2396450\" data-id=\"2396450\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c128e35 elementor-widget elementor-widget-menu-anchor\" data-id=\"c128e35\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"ch\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3b87731 elementor-widget elementor-widget-image\" data-id=\"3b87731\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"119\" height=\"150\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2019\/04\/BOLSA1.png\" class=\"attachment-thumbnail size-thumbnail wp-image-764\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Concentrado de Hem\u00e1cias - CH<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0d2e7ea elementor-widget elementor-widget-text-editor\" data-id=\"0d2e7ea\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>Volume:<\/b>\u00a0220 a 320 mL<br \/><b>Armazenamento:\u00a0<\/b>\u00a02\u00baC a 6\u00baC em c\u00e2mara de conserva\u00e7\u00e3o de hem\u00e1cias.\u00a0<br \/><b>Validade:\u00a0<\/b>depende do anticoagulante e solu\u00e7\u00e3o aditiva, variando de 28 com ACD, 35 dias com CPDA1 ou 42 dias com CPD e solu\u00e7\u00e3o\u00a0 de SAG-Manitol.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-fd9864f\" data-id=\"fd9864f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-93e07a9 elementor-widget elementor-widget-toggle\" data-id=\"93e07a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1551\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-1551\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Caracter\u00edsticas e conte\u00fado<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1551\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-1551\"><p>Cont\u00e9m hem\u00e1cias com hemat\u00f3crito entre 50-60% em unidades produzidas com solu\u00e7\u00e3o aditiva. Unidades produzidas sem solu\u00e7\u00e3o aditiva apresentam hemat\u00f3crito de at\u00e9 80%. Cont\u00e9m plasma residual (&lt;50 mL) e leuc\u00f3citos (podem ser removidos por filtra\u00e7\u00e3o pr\u00e9 ou p\u00f3s-armazenamento). A remo\u00e7\u00e3o dos leuc\u00f3citos pr\u00e9-armazenamento \u00e9 mais eficaz e apresenta melhores resultados cl\u00ednicos.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1552\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"button\" aria-controls=\"elementor-tab-content-1552\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Transfus\u00e3o no paciente sem sangramento<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1552\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"region\" aria-labelledby=\"elementor-tab-title-1552\"><p>A transfus\u00e3o de hem\u00e1cias deve ser considerada em pacientes an\u00eamicos por defici\u00eancia de ferro, vitaminas ou outras causas trat\u00e1veis de anemia apenas se instabilidade (hipotens\u00e3o arterial ou dispneia em repouso ou dor precordial ou altera\u00e7\u00e3o do n\u00edvel de consci\u00eancia).<\/p><p>N\u00e3o se justifica transfundir pacientes por indica\u00e7\u00f5es subjetivas como palidez, fraqueza, melhoria da cicatriza\u00e7\u00e3o de feridas ou corre\u00e7\u00e3o da hemoglobina para n\u00edveis pr\u00e9-determinados. O paciente com anemia cr\u00f4nica \u00e9 geralmente hipervol\u00eamico e desenvolve mecanismos fisiol\u00f3gicos de adapta\u00e7\u00e3o capazes de manter uma oferta adequada de oxig\u00eanio aos tecidos apesar da redu\u00e7\u00e3o da hemoglobina.<\/p><p><b>Avalie seu paciente<\/b>! Considerar apenas o n\u00edvel de hemoglobina n\u00e3o \u00e9 suficiente e aumenta as chances de transfus\u00f5es desnecess\u00e1rias.<\/p><p><b>Correla\u00e7\u00e3o da transfus\u00e3o com o n\u00edvel de hemoglobina:<br \/><\/b>1)\u00a0<b>Hemoglobina acima de 9 g\/dL\u00a0<\/b>\u00e9 bem tolerada e raramente acarreta repercuss\u00f5es, n\u00e3o havendo necessidade de corre\u00e7\u00e3o transfusional acima desses n\u00edveis.\u00a0<br \/>2)\u00a0<b>Hemoglobina abaixo de 7 g\/dL<\/b> pode estar associada a sinais e sintomas de redu\u00e7\u00e3o da oxigena\u00e7\u00e3o tecidual. A transfus\u00e3o apenas abaixo desse n\u00edvel \u00e9 considerada adequada na maioria das situa\u00e7\u00f5es (choque s\u00e9ptico, hemorragia digestiva alta sem sangramento atual e est\u00e1vel e cuidados intensivos).<br \/>3)\u00a0<b>Hemoglobina acima de 8 g\/dL<\/b> \u00e9 considerado um n\u00edvel seguro para a maioria das interven\u00e7\u00f5es cir\u00fargicas. A anemia identificada no pr\u00e9-operat\u00f3rio de procedimentos eletivos deve ser investigada e tratada corretamente.<\/p><p>O objetivo da transfus\u00e3o \u00e9 tirar o paciente dos n\u00edveis cr\u00edticos e manter hemoglobina entre\u00a0<b>7g\/dL e 9g\/dL<\/b>.\u00a0<br \/>Anemia n\u00e3o se trata com transfus\u00e3o.<\/p><p><b>H\u00e1 excess\u00f5es?<br \/><\/b>Pacientes com doen\u00e7as cardiovasculares pr\u00e9-existentes e est\u00e1veis, podem representar exce\u00e7\u00e3o a essa regra e poder\u00e3o ser transfundidos quando a hemoglobina for menor que 8g\/dL ou apresentarem sintomas relacionados ao quadro an\u00eamico. Em pacientes com infarto agudo do mioc\u00e1rdio ou angina inst\u00e1vel, transfus\u00e3o com Hb abaixo de 8 g\/dL \u00e9 t\u00e3o seguro quanto transfus\u00f5es com Hb maiores e est\u00e1 relacionada a menor frequ\u00eancia de complica\u00e7\u00f5es.<\/p><p><b>Mude o foco!<\/b>\u00a0Estamos transfundindo o paciente e n\u00e3o o hemograma! Busque a estabilidade cl\u00ednica e n\u00e3o um n\u00edvel espec\u00edfico de hemoglobina e hemat\u00f3crit<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1553\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"button\" aria-controls=\"elementor-tab-content-1553\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Transfus\u00e3o em situa\u00e7\u00e3o de emerg\u00eancia<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1553\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"region\" aria-labelledby=\"elementor-tab-title-1553\"><p><b>Essa transfus\u00e3o \u00e9 urgente e n\u00e3o pode esperar as provas de compatibilidade?<br \/>Calma! Existe uma solu\u00e7\u00e3o para isso!<\/b><\/p><p>A libera\u00e7\u00e3o de concentrado de hem\u00e1cias antes do t\u00e9rmino dos testes pr\u00e9-transfusionais pode ser feita, desde que obedecidas as seguintes condi\u00e7\u00f5es:<br \/>1. O quadro cl\u00ednico do paciente justifique a emerg\u00eancia, isto \u00e9, quando o retardo no in\u00edcio da transfus\u00e3o coloca em risco a vida do paciente. Lembrar que a libera\u00e7\u00e3o de um concentrado de hem\u00e1cias com seguran\u00e7a ocorrer\u00e1 em um prazo de 40 minutos ap\u00f3s a coleta da amostra.<br \/>2. O m\u00e9dico respons\u00e1vel pelo paciente assine a \u201cDeclara\u00e7\u00e3o de responsabilidade m\u00e9dica para transfus\u00f5es em situa\u00e7\u00f5es especiais\u201d constante na parte inferior da Requisi\u00e7\u00e3o de Transfus\u00e3o, no qual afirma expressamente o conhecimento do risco e concorde com a transfus\u00e3o.<\/p><p><b>Mas lembre:<\/b><br \/>A ag\u00eancia transfusional deve ser acionada o mais precocemente poss\u00edvel. Se n\u00e3o houver amostra do paciente no servi\u00e7o, essa deve ser colhida o mais r\u00e1pido poss\u00edvel e antes da transfus\u00e3o ou, excepcionalmente, antes da administra\u00e7\u00e3o de grande quantidade de hemocomponentes.<br \/>Quando n\u00e3o houver tempo para classificar o sangue do receptor devem ser liberados componentes universais (Concentrados de hem\u00e1cias O negativo (mulheres com menos de 50 anos) ou O positivo (demais casos), quando n\u00e3o houver tempo para tipar o sangue do receptor.<br \/>O envio da bolsa n\u00e3o implica na interrup\u00e7\u00e3o das provas pr\u00e9-transfusionais, que ser\u00e3o continuadas normalmente. Em caso de anormalidades nos testes, o m\u00e9dico ser\u00e1 imediatamente notificado.<\/p><p><b>Qual \u00e9 o risco?<\/b><br \/>Nessa situa\u00e7\u00e3o o m\u00e9dico abre m\u00e3o das provas de compatibilidade e o risco de rea\u00e7\u00f5es hemol\u00edticas aumenta em 1 a 1,5%, sendo maior em mulheres com gesta\u00e7\u00f5es anteriores e pacientes com hist\u00f3rico de transfus\u00f5es. Por isso \u00e9 uma exce\u00e7\u00e3o que precisa ter um protocolo escrito com fluxo aprovado pelo comit\u00ea transfusional de cada hospital.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1554\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"button\" aria-controls=\"elementor-tab-content-1554\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Transfus\u00e3o Intrauterina<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1554\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"region\" aria-labelledby=\"elementor-tab-title-1554\"><p>A transfus\u00e3o intrauterina est\u00e1 indicada quando o feto apresenta anemia grave, mais frequentemente associada \u00e0 doen\u00e7a hemol\u00edtica do feto e do rec\u00e9m-nascido (DHFRN). Outras causas de anemia fetal grave s\u00e3o a alfa-talassemia maior e parvovirose. Geralmente a transfus\u00e3o intrauterina \u00e9 indicada a partir de um ultrassom doppler de art\u00e9ria cerebral m\u00e9dia do feto indicando aumento da velocidade de fluxo. Apesar de a triagem por doppler ter boas sensibilidade e especificidade para anemia fetal, antes da transfus\u00e3o, deve ser coletada amostra por cordocentese para avalia\u00e7\u00e3o da hemoglobina e hemat\u00f3crito fetais. O objetivo da transfus\u00e3o \u00e9 manter uma hemoglobina que permita a continua\u00e7\u00e3o da gesta\u00e7\u00e3o para matura\u00e7\u00e3o pulmonar e hep\u00e1tica do feto.<\/p><p><strong>Lembre-se:<\/strong><br \/>A transfus\u00e3o intrauterina deve ser feita com concentrado de hem\u00e1cias &#8220;O&#8221; (geralmente RhD negativo), coletado h\u00e1 menos de 5 dias, leucorreduzido, irradiado nas \u00faltimas 24 horas, hemoglobina S negativo e, se em solu\u00e7\u00e3o aditiva, como SAG-Manitol, tamb\u00e9m deve ser lavado. Na DHFRN, o CH deve ser ant\u00edgeno negativo para o anticorpo em quest\u00e3o e preferencialmente respeitando a fenotipagem estendida da m\u00e3e. O preparo do concentrado de hem\u00e1cias tamb\u00e9m requer um ajuste do hemat\u00f3crito (normalmente entre 75-85%). N\u00e3o \u00e9 f\u00e1cil, n\u00e9?<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1555\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"button\" aria-controls=\"elementor-tab-content-1555\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Reserva cir\u00fargica<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1555\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"region\" aria-labelledby=\"elementor-tab-title-1555\"><p>A reserva cir\u00fargica de hemocomponentes consiste em compatibilizar unidades de CH antes do procedimento cir\u00fargico, de forma que permane\u00e7am dispon\u00edveis para um determinado paciente no trans-operat\u00f3rio e p\u00f3s-operat\u00f3rio imediato. Est\u00e1 relacionada ao potencial de sangramento do procedimento cir\u00fargico a que o paciente ser\u00e1 submetido e, eventualmente, ao risco de sangramento do paciente em fun\u00e7\u00e3o de caracter\u00edsticas cl\u00ednicas e de particularidades cir\u00fargicas.<br \/>Os\u00a0 componentes reservados n\u00e3o ser\u00e3o usados por outros pacientes at\u00e9 a finaliza\u00e7\u00e3o do procedimento cir\u00fargico.<\/p><p><strong>Reservas desnecess\u00e1rias podem inviabilizar outros procedimentos em virtude de eventuais limita\u00e7\u00f5es de estoque.<\/strong><\/p><p><strong>Que condutas pr\u00e9-operat\u00f3rias imediatas podem ser adotadas pelo servi\u00e7o de hemoterapia para maior seguran\u00e7a do paciente cir\u00fargico?<\/strong><\/p><ul><li><b>Procedimentos com potencial de sangramento pequeno\u00a0<\/b>(&lt;500mL): Nenhuma a\u00e7\u00e3o \u00e9 necess\u00e1ria, afinal s\u00e3o procedimentos com um risco remoto de necessidade transfusional. A libera\u00e7\u00e3o do sangue, se necess\u00e1rio, ser\u00e1 feita ap\u00f3s a realiza\u00e7\u00e3o dos testes pr\u00e9-transfusionais (classifica\u00e7\u00e3o<br \/>ABO e RhD e pesquisa de anticorpos irregulares do paciente, reclassifica\u00e7\u00e3o ABO do CH).\u00a0<br \/>Tempo de libera\u00e7\u00e3o: pelo menos 45 minutos ap\u00f3s chegada da amostra.<\/li><li><b>Procedimentos com potencial de sangramento maior<\/b>\u00a0(500 &#8211; 1.000 mL): Coleta de amostra, tipagem sangu\u00ednea e pesquisa de anticorpos irregulares (TS + PAI) no pr\u00e9-operat\u00f3rio, s\u00e3o procedimentos com hist\u00f3rico transfusional pequeno, por\u00e9m poss\u00edvel.<br \/>Tempo de libera\u00e7\u00e3o: 45 minutos.<\/li><li><b>Para procedimentos com grande potencial de sangramento<\/b>\u00a0 (&gt; 1.000mL): Reserva de unidades de CH j\u00e1 que existe grande potencial de transfus\u00e3o. O n\u00famero de unidades compatibilizadas varia de acordo com o hist\u00f3rico transfusional do<br \/>procedimento no hospital.\u00a0<br \/>Tempo de libera\u00e7\u00e3o: imediato.<\/li><\/ul><p><strong>Como construir um protocolo no seu hospital?<\/strong><\/p><p>Na constru\u00e7\u00e3o do protocolo \u00e9 recomendado:<br \/>1. Identificar os procedimentos cir\u00fargicos realizados no hospital por tipo.<br \/>2. Classificar por tipo de conduta de acordo com o potencial do sangramento.<br \/>3. Estabelecer retrospectivamente\u00a0 o n\u00famero de<br \/>transfus\u00f5es para cada tipo de procedimento cir\u00fargico realizado no hospital.\u00a0\u00a0<br \/>3. Discutir com cada cl\u00ednica cir\u00fargica e comit\u00ea transfusional a adequa\u00e7\u00e3o do hist\u00f3rico de transfus\u00f5es e potencial de sangramento no intraoperat\u00f3rio para definir a conduta para cada tipo de procedimento.\u00a0<br \/>4. O n\u00famero de unidades reservadas deve ser o mais pr\u00f3ximo poss\u00edvel do n\u00famero de transfus\u00f5es para cada tipo de cirurgia.\u00a0<\/p><p>Desvios identificados na pr\u00e1tica hospitalar ap\u00f3s essa discuss\u00e3o devem ser analisados e revistos.\u00a0<strong>Voc\u00ea pode estar diante de uma oportunidade de melhoria nesse momento. Aproveite!<\/strong><\/p><p>Existem tabelas com orienta\u00e7\u00f5es pr\u00e9-definidas publicadas<br \/>por institui\u00e7\u00f5es como a OMS, que podem ser \u00fateis para orientar o protocolo, no entanto, \u00e9 importante que o corpo cir\u00fargico do hospital esteja envolvido na defini\u00e7\u00e3o do protocolo<br \/>e fa\u00e7a as adapta\u00e7\u00f5es necess\u00e1rias para sua realidade.<\/p><p><strong>O Comit\u00ea Transfusional do hospital \u00e9 muito importante na condu\u00e7\u00e3o desse processo.<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1556\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"button\" aria-controls=\"elementor-tab-content-1556\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Prescri\u00e7\u00e3o<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1556\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"region\" aria-labelledby=\"elementor-tab-title-1556\"><p>Nos primeiros 10 minutos, a transfus\u00e3o de CH deve ser realizada a 15 gotas por minuto sob observa\u00e7\u00e3o para permitir a identifica\u00e7\u00e3o precoce de rea\u00e7\u00f5es imediatas graves.\u00a0<\/p><p><span style=\"font-size: 1rem;\">Ap\u00f3s esse per\u00edodo obrigat\u00f3rio de gotejamento lento a infus\u00e3o deve ser ajustada para gotejamento de acordo com a situa\u00e7\u00e3o cl\u00ednica do paciente, habitualmente, 50 gt\/min.<\/span><\/p><p>1 CH pode ser habitualmente infundido em 2 horas, e nunca pode ultrapassar 4 horas. Em pacientes idosos, nefropatas, cardiopatas ou com sobrecarga vol\u00eamica, o CH deve ser infundido na velocidade de 1mL\/kg do receptor\/hora, at\u00e9 o tempo m\u00e1ximo de 4 horas.<\/p><p><b>Recomenda\u00e7\u00f5es importantes:<\/b><\/p><p>1.Evitar transfus\u00f5es eletivas \u00e0 noite.<\/p><p>2. Em pacientes\u00a0<b>SEM<\/b>\u00a0sangramento ativo transfundir de prefer\u00eancia apenas uma unidade de hem\u00e1cias, e reavaliar clinicamente antes da prescri\u00e7\u00e3o da segunda unidade.<\/p><p>3. \u00c9 obrigat\u00f3rio o uso de equipo de transfus\u00e3o com dupla c\u00e2mara e filtro para macroagregados (200\u03bc).<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1557\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"button\" aria-controls=\"elementor-tab-content-1557\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dose<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1557\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"region\" aria-labelledby=\"elementor-tab-title-1557\"><p>Habitualmente a transfus\u00e3o de 1 unidade de CH \u00e9 suficiente e mais do que o necess\u00e1rio para estabilizar o paciente sem sangramento grave. Se voc\u00ea precisa mesmo de um par\u00e2metro,\u00a0 a dose de 4 mL\/Kg de peso eleva aproximadamente 1g\/dL na hemoglobina e 3% no hemat\u00f3crito.<\/p><p>Em neonatos e crian\u00e7as a dose recomendada \u00e9 10-20 mL\/kg, geralmente 15 mL\/kg<\/p><p><span style=\"font-weight: bold;\">N\u00e3o h\u00e1 necessidade de coletar hemograma no paciente sem sangramento. Busque a estabilidade cl\u00ednica. O foco \u00e9 o paciente.<\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1558\" class=\"elementor-tab-title\" data-tab=\"8\" role=\"button\" aria-controls=\"elementor-tab-content-1558\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Desleucocita\u00e7\u00e3o, irradia\u00e7\u00e3o e outros<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1558\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"8\" role=\"region\" aria-labelledby=\"elementor-tab-title-1558\"><p><strong>Desleucocita\u00e7\u00e3o:<\/strong><\/p><p>\u00c9 o procedimento realizado atrav\u00e9s de filtros espec\u00edficos para remo\u00e7\u00e3o de leuc\u00f3citos de um componente sangu\u00edneo celular (gl\u00f3bulos vermelhos e plaquetas). Os leuc\u00f3citos s\u00e3o associados a v\u00e1rias rea\u00e7\u00f5es transfusionais, como rea\u00e7\u00e3o febril n\u00e3o hemol\u00edtica (RFNH), aloimuniza\u00e7\u00e3o e refratariedade plaquet\u00e1ria por exemplo e podem estar associados \u00e0 transmiss\u00e3o de pat\u00f3genos\u00a0 intraleucocit\u00e1rios,\u00a0 como Citomegalov\u00edrus, Leishmania\u00a0<em>sp<\/em>, HTLV I\/II entre outros. Por isso, devem ser removidos do componente\u00a0 para prevenir rea\u00e7\u00f5es ou reduzir o risco da transfus\u00e3o.\u00a0Uma unidade de sangue total cont\u00e9m cerca de 2 a 3 x10E9 leuc\u00f3citos e a desleucocita\u00e7\u00e3o reduz \u00a099,99% dos leuc\u00f3citos presentes no sangue doador. O\u00a0componente desleucocitado cont\u00e9m menos que 5x10E6 leuc\u00f3citos.\u00a0<\/p><p>A filtra\u00e7\u00e3o n\u00e3o altera o tempo de\u00a0\u00a0validade do componente\u00a0se feito em\u00a0 sistema fechado e \u00e9 mais\u00a0eficaz quando feita\u00a0antes do armazenamento do\u00a0componente, utilizando sistemas de bolsas com filtro\u00a0<em>in line<\/em>.<\/p><p>Principais indica\u00e7\u00f5es da desleucocit\u00e7\u00e3o:<\/p><ul><li>Pacientes com potencial de politransfus\u00e3o, como pessoas com doen\u00e7a falciforme e outras doen\u00e7as hematol\u00f3gicas\u00a0benignas e onco-hematol\u00f3gicas (Aplasia medular, hemoglobinopatias e outras anemias hemol\u00edticas heredit\u00e1rias).<\/li><li>Hist\u00f3ria de RFNH.<\/li><li>Pr\u00e9 e p\u00f3s transplante de medula \u00f3ssea e de \u00f3rg\u00e3os s\u00f3lidos.<\/li><li>Insufici\u00eancia Renal Cr\u00f4nica com indica\u00e7\u00e3o para transplante renal.<\/li><li>Na preven\u00e7\u00e3o de transmiss\u00e3o de CMV em:<br \/>&#8211; Paciente HIV positivo com sorologia CMV negativa.<br \/>&#8211; Candidato a transplante de \u00f3rg\u00e3os e medula \u00f3ssea se doador e receptor forem CMV negativos.<br \/>&#8211; Transfus\u00e3o intrauterina.\u00a0<br \/>&#8211; Gestantes com sorologia n\u00e3o-reativa ou desconhecida para CMV.\u00a0<br \/>&#8211; Rec\u00e9m-nascidos prematuros e de baixo peso (1.200g) de m\u00e3es CMV negativas ou com sorologia desconhecida.<\/li><\/ul><p><strong>Irradia\u00e7\u00e3o:<\/strong><\/p><p>Procedimento realizado atrav\u00e9s da exposi\u00e7\u00e3o dos hemocomponentes celulares \u00e0 irradia\u00e7\u00e3o gama na dose de 2500cGy (25Gy), impossibilitando a multiplica\u00e7\u00e3o dos linf\u00f3citos.\u00a0A irradia\u00e7\u00e3o dos hemocomponentes \u00e9 realizada para a preven\u00e7\u00e3o da doen\u00e7a do enxerto versus hospedeiro associada \u00e0 transfus\u00e3o (DECH-AT), rea\u00e7\u00e3o transfusional tardia\u00a0imunol\u00f3gica, usualmente fatal, causada pelos linf\u00f3citos do doador em receptores suscet\u00edveis. Quando realizado em equipamento espec\u00edfico para irradia\u00e7\u00e3o celular apresenta maior efic\u00e1cia do que em equipamentos de acelera\u00e7\u00e3o linear. A irradia\u00e7\u00e3o altera o tempo de validade das hem\u00e1cias para 28 dias. As plaquetas n\u00e3o t\u00eam sua validade alterada pela irradia\u00e7\u00e3o.<\/p><p>Principais indica\u00e7\u00f5es da irradia\u00e7\u00e3o:<\/p><ul><li>Transfus\u00e3o intra-uterina.\u00a0<\/li><li>Exsangu\u00edneo-transfus\u00e3o, obrigatoriamente, quando houver transfus\u00e3o intra-uterina pr\u00e9via.<\/li><li>Rec\u00e9m-nascidos prematuros (inferior a 28 semanas) e\/ou de baixo peso (1.200g).<\/li><li>Portadores de imunodefici\u00eancias cong\u00eanitas graves.<\/li><li>P\u00f3s transplante de medula \u00f3ssea aut\u00f3logo ou alog\u00eanico.<\/li><li>P\u00f3s transplante com c\u00e9lulas de cord\u00e3o umbilical.<\/li><li>Pacientes tratados com an\u00e1logos da purina, fludarabina, cladribine, deoxicoformicina.<\/li><li>Receptor de transplante de cora\u00e7\u00e3o ou pulm\u00e3o.<\/li><li>Portadores de linfomas, leucemia miel\u00f3ide aguda e anemia apl\u00e1stica em uso de imunossupressor.<\/li><li>Receptor de concentrado de plaquetas HLA compat\u00edveis.<\/li><li>Quando o receptor e doador apresentarem algum grau de parentesco (filhos, pais, irm\u00e3os, tios, primos).<\/li><\/ul><p><strong>Lavagem:\u00a0<\/strong><\/p><p>Procedimento obtido atrav\u00e9s da suspens\u00e3o de hem\u00e1cias e plaquetas com solu\u00e7\u00e3o isot\u00f4nica de cloreto de s\u00f3dio est\u00e9ril em quantidade suficiente (1 a 3 litros) para eliminar a maior quantidade poss\u00edvel de plasma (prote\u00ednas totais &lt; 500 mg\/U). \u00c9 realizada em sistema aberto, em capela de fluxo laminar, em ciclos sucessivos de centrifuga\u00e7\u00e3o do componente e retirada do sobrenadante. Os componentes lavados tem validade de 24 horas ap\u00f3s o procedimento em virtude do risco de contamina\u00e7\u00e3o bacteriana (sistema aberto).\u00a0<\/p><p>Principais indica\u00e7\u00f5es:<\/p><ul><li>Pacientes com defici\u00eancia de IgA e hist\u00f3ria de rea\u00e7\u00e3o anafil\u00e1tica em transfus\u00f5es anteriores.<\/li><li>Rea\u00e7\u00f5es al\u00e9rgicas graves.<\/li><\/ul><p><strong>Fenotipagem eritrocit\u00e1ria:<\/strong><\/p><p>Determina\u00e7\u00e3o dos ant\u00edgenos presentes nas hem\u00e1cias para outros ant\u00edgenos eritrocit\u00e1rios al\u00e9m do sistema ABO e do ant\u00edgeno D do sistema Rh. Existem 43 sistemas de grupos sangu\u00edneos cerca de 380 ant\u00edgenos eritrocit\u00e1rios distintos. Os que apresentam import\u00e2ncia cl\u00ednica s\u00e3o aqueles associados a rea\u00e7\u00e3o hemol\u00edtica aguda ou tardia ou doen\u00e7a hemol\u00edtica perinatal.<\/p><p>Recomenda-se a fenotipagem do paciente e a utiliza\u00e7\u00e3o de concentrado de hem\u00e1cias fenotipado para receptores que est\u00e3o ou poder\u00e3o entrar em esquema de transfus\u00e3o cr\u00f4nica. A maioria desses pacientes se beneficia de compatibilidades mais simples, contra os principais ant\u00edgenos do sistema Rh (D, C, c, E, e) e K. A utiliza\u00e7\u00e3o de CH respeitando a fenotipagem estendida (Rh, Kell, Duffy, Kidd e MNS) tem particular import\u00e2ncia para pacientes falciformes, talass\u00eamicos e aqueles previamente aloimunizados.<\/p><p>Em receptores com Pesquisa de Anticorpo Irregular positiva, realizar transfus\u00e3o de concentrado de hem\u00e1cias (CH) ant\u00edgeno negativo para o anticorpo em quest\u00e3o.<\/p><p>Lembrar que 60% das PAI negativam ap\u00f3s 3 meses,\u00a0 por isso \u00e9 obrigat\u00f3rio respeitar para sempre o anticorpo identificado previamente atrav\u00e9s do hist\u00f3rico transfusional do paciente.<br \/>Essa informa\u00e7\u00e3o fica dispon\u00edvel no sistema informatizado do Hemoce e deve ser buscada &#8211; OBRIGATORIAMENTE &#8211; sempre que o paciente for transfundido.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1559\" class=\"elementor-tab-title\" data-tab=\"9\" role=\"button\" aria-controls=\"elementor-tab-content-1559\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Compatibilidade<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1559\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"9\" role=\"region\" aria-labelledby=\"elementor-tab-title-1559\"><p>A transfus\u00e3o de concentrado de hem\u00e1cias (CH) necessita da realiza\u00e7\u00e3o pr\u00e9via de prova de compatibilidade. Veja os detalhes na p\u00e1gina de testes pr\u00e9-transfusionais.<\/p><p><strong>Compatibilidade ABO:<\/strong> <br \/>Usar preferencialmente CH ABO id\u00eantico ao paciente. Entretanto, na indisponibilidade de componente id\u00eantico podem ser usados CH ABO compat\u00edveis. O CH O pode ser usado em qualquer grupo. O CH A pode ser usado em pacientes A e AB. O CH B pode ser usado em pacientes B e AB e o CH AB somente em pacientes AB.<\/p><p><strong>Compatibilidade RhD:<\/strong> <br \/>O RhD deve ser respeitado em toda transfus\u00e3o de CH. Na indisponibilidade de CH RhD negativo no estoque e em situa\u00e7\u00f5es emergenciais, CH RhD positivo pode ser usado em pacientes sem hist\u00f3rico de anticorpo anti-D. Entretanto o uso de CH RhD incompat\u00edvel deve ser evitado ao m\u00e1ximo em mulheres com menos de 50 anos, pelo risco de desenvolvimento de doen\u00e7a hemol\u00edtica do feto e do rec\u00e9m-nascido no futuro.<\/p><p><strong>E o tal do CDE?<\/strong><br \/>Amostras de doadores RhD negativo s\u00e3o avaliadas por dois testes adicionais: a pesquisa do D fraco e a triagem para CDE. A pesquisa de D fraco \u00e9 um m\u00e9todo mais sens\u00edvel que o teste habitual para detec\u00e7\u00e3o de pequenas quantidades de ant\u00edgenos D na superf\u00edcie das hem\u00e1cias. Somente quando a pesquisa de D fraco \u00e9 negativa,\u00a0 o concentrado de hem\u00e1cias \u00e9 rotulado como RhD negativo. Nas amostras com resultados negativos no teste inicial e na pesquisa de D fraco, \u00e9 realizado um outro teste para triagem para os ant\u00edgenos D, C e E. A presen\u00e7a de C e\/ou E pode indicar a presen\u00e7a de quantidades muito pequenas de D, imposs\u00edveis de serem detectadas nos testes sorol\u00f3gicos convencionais. Portanto, unidades de CH RhD negativo com CDE positivo devem ser evitados em pacientes do sexo feminino com menos de 50 anos.<\/p><p>Amostras de doadores RhD negativo s\u00e3o avaliadas por dois testes adicionais: a pesquisa do D fraco e a triagem para CDE ou fenotipagem para C, c, E, e.<\/p><p>\u00a0<\/p><p><strong>Lembre: compat\u00edvel n\u00e3o \u00e9 igual!<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-15510\" class=\"elementor-tab-title\" data-tab=\"10\" role=\"button\" aria-controls=\"elementor-tab-content-15510\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dicas do EducaSangue<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-15510\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"10\" role=\"region\" aria-labelledby=\"elementor-tab-title-15510\"><p>Conhe\u00e7a as dicas do\u00a0<a href=\"https:\/\/preservasangue.com.br\/index.php\/educasangue\/\">EducaSangue<\/a> sobre transfus\u00e3o de hem\u00e1cias e aprenda de forma r\u00e1pida e divertida como indicar e prescrever esse componente.\u00a0<br \/>Existem muitas particularidades que voc\u00ea precisa conhecer.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-eb306d1 elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"eb306d1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-burn\"><\/i><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-94f1539 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"94f1539\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ea8b8c1\" data-id=\"ea8b8c1\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-f711bd1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f711bd1\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-6c8724e\" data-id=\"6c8724e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-476a33f elementor-widget elementor-widget-menu-anchor\" data-id=\"476a33f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"cp\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-91163e1 elementor-widget elementor-widget-image\" data-id=\"91163e1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"119\" height=\"150\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2019\/04\/BOLSA2.png\" class=\"attachment-thumbnail size-thumbnail wp-image-765\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Concentrado de Plaquetas - CP<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f947540 elementor-widget elementor-widget-text-editor\" data-id=\"f947540\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: bold;\">Volume: <\/span>uma dose para adulto tem volume em torno de 200 a 300 mL (ver abaixo).<br \/><span style=\"font-weight: bold;\">Armazenamento:<\/span>\u00a020\u00baC a 24\u00baC sob agita\u00e7\u00e3o cont\u00ednua.\u00a0<br \/><span style=\"font-weight: bold;\">Validade:\u00a0<\/span>5 dias ap\u00f3s a coleta.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-746dec3\" data-id=\"746dec3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3474af7 elementor-widget elementor-widget-toggle\" data-id=\"3474af7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5501\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-5501\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Caracter\u00edsticas e conte\u00fado<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5501\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-5501\"><p>Cont\u00e9m plasma residual e leuc\u00f3citos (podem ser removidos por filtra\u00e7\u00e3o pr\u00e9 ou p\u00f3s armazenamento).<br \/>1)\u00a0<b>CP obtido de ST:<\/b>\u00a0Plaquetas &gt; 5,5 X 10E10, volume 50-60 mL. Dose de 6 a 8 unidades para um adulto.<br \/>2)\u00a0<b>CP obtido por af\u00e9rese:<\/b>\u00a0Plaquetas &gt; 3,0 X 10E11, volume 200-300mL. Dose de 1 unidade para um adulto.<br \/>3)\u00a0<b>CP obtido do buffy-coat:<\/b>\u00a0Plaquetas &gt; 2,5 x 10E11, volume 300-350 mL. Dose de 1 unidade para um adulto.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5502\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"button\" aria-controls=\"elementor-tab-content-5502\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Transfus\u00e3o profil\u00e1tica<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5502\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"region\" aria-labelledby=\"elementor-tab-title-5502\"><p>Transfus\u00e3o em pacientes com trombocitopenia e\u00a0<b>SEM<\/b>\u00a0sinais de hemorragia. Nesse caso, o\u00a0paciente n\u00e3o est\u00e1 sangrando e o objetivo \u00e9 prevenir hemorragias espont\u00e2neas, especialmente em SNC.<\/p><p><b>Em que situa\u00e7\u00f5es a transfus\u00e3o profil\u00e1tica est\u00e1 justificada:<\/b><\/p><p>1. Pacientes oncol\u00f3gicos, hematol\u00f3gicos ou p\u00f3s Transplante de Medula \u00d3ssea sem sepse ou febre com contagem inferior a 10.000\/\u03bcL<br \/>2. Pacientes oncol\u00f3gicos, hematol\u00f3gicos ou p\u00f3s Transplante de Medula \u00d3ssea com fatores de risco para sangramento com contagem inferior a 20.000\/\u03bcL<br \/>3. Pacientes com leucemia promieloc\u00edtica (LMA-M3) com contagem inferior a 50.000\/\u03bcL, quando na fase de CIVD<\/p><p>Em que situa\u00e7\u00f5es a transfus\u00e3o profil\u00e1tica N\u00c3O est\u00e1 justificada:<\/p><p>1. P\u00farpura trombocitop\u00eanica tromb\u00f3tica<br \/>2. Trombocitopenia imune\u00a0<br \/>3. Trombocitopenia induzida por heparina<\/p><p><b>Lembre:<\/b><br \/>A decis\u00e3o de transfundir plaquetas deve ser precedida, sempre que poss\u00edvel, de uma avalia\u00e7\u00e3o cl\u00ednica para identificar a causa da trombocitopenia e estabelecimento da terap\u00eautica apropriada.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5503\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"button\" aria-controls=\"elementor-tab-content-5503\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Gravidade do sangramento (OMS)<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5503\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"region\" aria-labelledby=\"elementor-tab-title-5503\"><p>Escala de gravidade de sangramento (OMS)<br \/>Grau 0: aus\u00eancia de sangramento<br \/>Grau 1 (sangramento m\u00ednimo): pet\u00e9quias\/equimoses, epistaxe ou sangramento orofar\u00edngeo por menos de 1h, sangramento oculto nas fezes (tra\u00e7o a 1+), hemoglobin\u00faria (tra\u00e7o a 1+), hemorragia retiniana sem redu\u00e7\u00e3o de acuidade visual, sangramento transvaginal m\u00ednimo.<br \/>Grau 2 (sangramento leve): melena, hemat\u00eamese, hemoptise, hemat\u00faria, hematoquezia ou sangramento transvaginal que n\u00e3o demande transfus\u00e3o de hem\u00e1cias ou aumente a necessidade transfusional previamente existente; epistaxe ou sangramento orofar\u00edngeo por mais de 1h, sangramento oculto nas fezes (2+ ou mais), hemoglobin\u00faria (2+ ou mais).<br \/>Grau 3 (sangramento maior) &#8211; melena, hemat\u00eamese, hemoptise, hemat\u00faria, hematoquezia, sangramento transvaginal, epistaxe, sangramento orofar\u00edngeo, hemoglobin\u00faria que demande transfus\u00e3o de mais de 1-2 concentrados de hem\u00e1cias\/dia, sangramento de SNC detectado por tomografia sem consequ\u00eancias clinicas, sangramento em s\u00edtio de pun\u00e7\u00e3o venosa profunda que demande transfus\u00e3o de CH.<br \/>Grau 4 (sangramento grave) &#8211; hemorragia retiniana com redu\u00e7\u00e3o de acuidade visual, sangramento de SNC com consequ\u00eancias cl\u00ednicas, sangramento em \u00f3rg\u00e3os vitais (hemorragia pulmonar, hemoperic\u00e1rdio etc.), sangramento maci\u00e7o com instabilidade hemodin\u00e2mica, hemorragia potencialmente fatal independente da localiza\u00e7\u00e3o.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5504\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"button\" aria-controls=\"elementor-tab-content-5504\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Transfus\u00e3o terap\u00eautica<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5504\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"region\" aria-labelledby=\"elementor-tab-title-5504\"><p>Refere-se \u00e0 transfus\u00e3o de plaquetas em pacientes com trombocitopenia e hemorragia ativa.<br \/>Sangramento ativo graus 2-4 (escala da OMS): \u2264 50.000\/\u03bcL<br \/>Sangramento em sistema nervoso central: \u2264 100.000\/\u03bcL<br \/>Sangramento (graus 2-4) em pacientes portadores de disfun\u00e7\u00e3o plaquet\u00e1ria cong\u00eanita ou adquirida (inclusive por uso de drogas antiagregantes ou AINES) independente da contagem de plaquetas. No caso de disfun\u00e7\u00e3o por antiagregante plaquet\u00e1rio e sangramento em sistema nervoso central, a transfus\u00e3o de plaquetas est\u00e1 contraindicada por aumentar morbimortalidade.<br \/>Transfus\u00e3o maci\u00e7a com sangramento ou altera\u00e7\u00e3o da coagula\u00e7\u00e3o: \u2264 50.000\/\u03bcL ou \u2264100.000\/\u03bcL se sangramento em sistema nervoso central.<br \/>Coagula\u00e7\u00e3o intravascular disseminada com sangramento: \u2264 50.000\/\u03bcL<\/p><p><strong>Mas lembre:<\/strong><br \/>A transfus\u00e3o de plaquetas est\u00e1 contraindicada na disfun\u00e7\u00e3o plaquet\u00e1ria da uremia. Nesses pacientes, a orienta\u00e7\u00e3o \u00e9 caprichar na di\u00e1lise e considerar o uso de desmopressina e estr\u00f3genos. A plaqueta transfundida no paciente ur\u00eamico perde sua fun\u00e7\u00e3o imediatamente ap\u00f3s sua entrada na circula\u00e7\u00e3o &#8211; \u00e9 o cl\u00e1ssico risco sem benef\u00edcio!<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5505\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"button\" aria-controls=\"elementor-tab-content-5505\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Transfus\u00e3o no pr\u00e9-operat\u00f3rio<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5505\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"region\" aria-labelledby=\"elementor-tab-title-5505\"><p>Se o paciente com trombocitopenia precisa se submeter a uma interven\u00e7\u00e3o cir\u00fargica, a habilidade e a experi\u00eancia da equipe cir\u00fargica s\u00e3o preponderantes para definir o risco de sangramento.<\/p><p><b>Em que situa\u00e7\u00f5es a transfus\u00e3o de\u00a0 plaquetas antes de um procedimento invasivo est\u00e1 justificada:<\/b><\/p><p>&#8211; Acesso central:\u00a0 \u2264 20.000 &#8211; 30.000\/\u03bcL \u2013 fazer guiado por ultrassom sempre que poss\u00edvel<br \/>&#8211; Biopsia hep\u00e1tica: \u2264 50.000\/\u03bcL<br \/>&#8211; Broncoscopia sem bi\u00f3psia: \u2264 20.000 &#8211; 40.000\/\u03bcL<br \/>&#8211; Broncoscopia com bi\u00f3psia: \u2264 50.000\/\u03bcL<br \/>&#8211; Cirurgias de m\u00e9dio e grande porte: \u2264 50.000\/\u03bcL<br \/>&#8211; Cirurgias de c\u00e2mara posterior do olho e SNC: \u2264 100.000\/\u03bcL<br \/>&#8211; Endoscopia digestiva sem bi\u00f3psia: \u2264 20.000 &#8211; 40.000\/\u03bcL<br \/>&#8211; Endoscopia digestiva com bi\u00f3psia: \u2264 50.000\/\u03bcL<br \/>&#8211; Pun\u00e7\u00e3o lombar para coleta de l\u00edquor ou quimioterapia: \u2264 40.000-50.000\/\u03bcL<\/p><p>Em todos os casos acima, recomenda-se iniciar a transfus\u00e3o profil\u00e1tica 30 minutos antes do procedimento cir\u00fargico, assegurar a disponibilidade de CP durante a realiza\u00e7\u00e3o do procedimento, para o caso de haver necessidade de novas transfus\u00f5es e evitar coletar hemograma p\u00f3s-transfusional para n\u00e3o retardar a realiza\u00e7\u00e3o do procedimento.<\/p><p><b>Em que situa\u00e7\u00f5es a transfus\u00e3o de plaquetas\u00a0N\u00c3O\u00a0est\u00e1 justificada mesmo antes de um procedimento invasivo:<\/b><\/p><p>&#8211; Pun\u00e7\u00e3o ou bi\u00f3psia de medula \u00f3ssea e para a retirada de\u00a0 cateter central tunelado e n\u00e3o tunelado<br \/>&#8211; Esplenectomia na PTI.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5506\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"button\" aria-controls=\"elementor-tab-content-5506\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Refratariedade Plaquet\u00e1ria<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5506\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"region\" aria-labelledby=\"elementor-tab-title-5506\"><p><strong>Voc\u00ea acha que a plaqueta n\u00e3o sobe?<\/strong><\/p><p>A transfus\u00e3o de plaquetas, apesar de habitualmente ser capaz de reduzir o risco ou levar \u00e0 resolu\u00e7\u00e3o de sangramento associado \u00e0 trombocitopenia, pode n\u00e3o &#8220;funcionar&#8221;. Um aumento menor do que o esperado pode acontecer em 20 a 70% dos pacientes politransfundidos com trombocitopenia.<\/p><p>A resposta \u00e0 transfus\u00e3o de plaquetas deve ser avaliada com uma contagem plaquet\u00e1ria de 10 a 60 minutos ap\u00f3s o t\u00e9rmino da transfus\u00e3o. A partir desse valor, da contagem plaquet\u00e1ria pr\u00e9-transfus\u00e3o, da superf\u00edcie corp\u00f3rea do paciente e da contagem estimada de plaquetas no concentrado de plaquetas (CP) transfundido, podemos fazer o chamado CCI (c\u00e1lculo do incremento corrigido).<\/p><p><em> Quer uma ajuda para calcular o CCI? Baixe o app do Educasangue!<\/em><\/p><p>CCI menores que 5000 a 7500 em duas transfus\u00f5es consecutivas de CP ABO compat\u00edveis s\u00e3o indicativos de REFRATARIEDADE \u00c0 TRANSFUS\u00c3O DE PLAQUETAS.<\/p><p>As causas mais comuns para que uma transfus\u00e3o n\u00e3o renda adequadamente s\u00e3o chamadas n\u00e3o-imunes: sangramento grave, coagula\u00e7\u00e3o intravascular disseminada, hiperesplenismo, febre, sepse, transplante de medula \u00f3ssea alog\u00eanico e uso de algumas drogas com infus\u00e3o pr\u00f3xima ao momento da transfus\u00e3o, como vancomicina e anfotericina.<\/p><p>Outra raz\u00f5es n\u00e3o-imunes de incremento inadequado se referem \u00e0 etiologia da trombocitopenia: microangiopatias tromb\u00f3ticas, como a P\u00farpura Trombocitop\u00eanica Tromb\u00f3tica (PTT), est\u00e3o associados a consumo r\u00e1pido da plaqueta transfundida (e lembre-se, al\u00e9m de ineficaz, a transfus\u00e3o de plaquetas na PTT est\u00e1 associada a aumento da mortalidade).<\/p><p>Em torno de 20% dos casos, entretanto, fatores imunes contribuem para incrementos inadequados. Anticorpos anti-HLA s\u00e3o os grandes vil\u00f5es, seguidos de anticorpos anti-HPA. HLA s\u00e3o mol\u00e9culas presentes em diversas c\u00e9lulas do corpo, entre elas, as plaquetas. HPA s\u00e3o ant\u00edgenos espec\u00edficos das plaquetas.<\/p><p>Na d\u00favida, colha contagem de plaquetas p\u00f3s e calcule o incremento!!<\/p><p>Ap\u00f3s a confirma\u00e7\u00e3o de incremento inadequado de prov\u00e1vel causa imune, deve-se evitar transfus\u00f5es profil\u00e1ticas enquanto n\u00e3o h\u00e1 doadores HLA espec\u00edficos. Se paciente apresentar sangramento grave, converse com seu hemoterapeuta. Existem algumas alternativas que podem ser avaliadas, como uso de antifibrinol\u00edticos e infus\u00e3o cont\u00ednua de plaquetas.<img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2911\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/05\/Caculo-CCI.jpeg\" alt=\"\" width=\"1280\" height=\"686\" \/><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5507\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"button\" aria-controls=\"elementor-tab-content-5507\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Prescri\u00e7\u00e3o<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5507\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"region\" aria-labelledby=\"elementor-tab-title-5507\"><p>Tempo m\u00e9dio de infus\u00e3o de 30 minutos, por\u00e9m pela possibilidade de sobrecarga circulat\u00f3ria associada \u00e0 transfus\u00e3o alguns servi\u00e7os recomendam transfus\u00e3o habitual em 1 a 2 horas.<\/p><p>Em pacientes com insufici\u00eancia renal, card\u00edaca ou idosos, pode-se fazer uma infus\u00e3o mais lenta, que n\u00e3o ultrapasse o tempo m\u00e1ximo de 4 horas desde a libera\u00e7\u00e3o pela ag\u00eancia transfusional.<\/p><p>Intervalo de 24 horas entre doses (geralmente suficiente para manter os n\u00edveis de plaquetas desejados).<\/p><p><b>Recomenda\u00e7\u00f5es importantes:<\/b><\/p><p>Em caso de hemorragia, a parada do sangramento deve ser o par\u00e2metro principal na decis\u00e3o ou n\u00e3o de novas transfus\u00f5es.<\/p><p>O controle da eleva\u00e7\u00e3o de plaquetas, na suspeita de refratariedade, pode ser feita com contagem plaquet\u00e1ria 10 a 60 min ap\u00f3s o t\u00e9rmino da transfus\u00e3o. O incremento deve ser calculado levando em conta superf\u00edcie corp\u00f3rea e dose plaquet\u00e1ria administrada. Sempre considerar fatores relacionados \u00e0 refratariedade n\u00e3o-imune (esplenomegalia, febre, infec\u00e7\u00e3o, antibi\u00f3ticos). Na suspeita de refratariedade, o hemoterapeuta da ag\u00eancia transfusional deve ser sempre consultado.<\/p><p>\u00c9 obrigat\u00f3rio o uso de equipo de transfus\u00e3o com filtro para microagregados (200\u03bc).<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5508\" class=\"elementor-tab-title\" data-tab=\"8\" role=\"button\" aria-controls=\"elementor-tab-content-5508\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dose<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5508\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"8\" role=\"region\" aria-labelledby=\"elementor-tab-title-5508\"><p>Uma unidade colhida por af\u00e9rese e um pool preparado a partir do buffy-coat apresentam um n\u00famero de plaquetas correspondente a uma dose para um paciente adulto. Quatro a seis unidades de plaquetas rand\u00f4micas correspondem \u00e0 mesma dose.<\/p><p>Em neonatos e crian\u00e7as a dose recomendada \u00e9 10-20 mL\/kg<\/p><p><b>N\u00e3o \u00e9 necess\u00e1rio fazer doses mais altas.<\/b><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-5509\" class=\"elementor-tab-title\" data-tab=\"9\" role=\"button\" aria-controls=\"elementor-tab-content-5509\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Desleucocita\u00e7\u00e3o, irradia\u00e7\u00e3o e outros<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-5509\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"9\" role=\"region\" aria-labelledby=\"elementor-tab-title-5509\"><p><strong>Desleucocita\u00e7\u00e3o:<\/strong><\/p><p>\u00c9 o procedimento realizado atrav\u00e9s de filtros espec\u00edficos para remo\u00e7\u00e3o de leuc\u00f3citos de um componente sangu\u00edneo celular (gl\u00f3bulos vermelhos e plaquetas). Os leuc\u00f3citos s\u00e3o associados a v\u00e1rias rea\u00e7\u00f5es transfusionais, como rea\u00e7\u00e3o febril n\u00e3o hemol\u00edtica (RFNH), aloimuniza\u00e7\u00e3o e refratariedade plaquet\u00e1ria por exemplo e podem estar associados \u00e0 transmiss\u00e3o de pat\u00f3genos\u00a0 intraleucocit\u00e1rios,\u00a0 como Citomegalov\u00edrus, Leishmania\u00a0<em>sp<\/em>, HTLV I\/II entre outros. Por isso, devem ser removidos do componente\u00a0 para prevenir rea\u00e7\u00f5es ou reduzir o risco da transfus\u00e3o.\u00a0Uma unidade de sangue total cont\u00e9m cerca de 2 a 3 x10E9 leuc\u00f3citos e a desleucocita\u00e7\u00e3o reduz \u00a099,99% dos leuc\u00f3citos presentes no sangue doador. O\u00a0componente desleucocitado cont\u00e9m menos que 5x10E6 leuc\u00f3citos.\u00a0<\/p><p>A filtra\u00e7\u00e3o n\u00e3o altera o tempo de\u00a0\u00a0validade do componente\u00a0se feito em\u00a0 sistema fechado e \u00e9 mais\u00a0eficaz quando feita\u00a0antes do armazenamento do\u00a0componente, utilizando sistemas de bolsas com filtro\u00a0<em>in line<\/em>.<\/p><p>Principais indica\u00e7\u00f5es da desleucocit\u00e7\u00e3o:<\/p><ul><li>Pacientes com potencial de politransfus\u00e3o, como pessoas com doen\u00e7a falciforme e outras doen\u00e7as hematol\u00f3gicas\u00a0benignas e onco-hematol\u00f3gicas (Aplasia medular, hemoglobinopatias e outras anemias hemol\u00edticas heredit\u00e1rias).<\/li><li>Hist\u00f3ria de RFNH.<\/li><li>Pr\u00e9 e p\u00f3s transplante de medula \u00f3ssea e de \u00f3rg\u00e3os s\u00f3lidos.<\/li><li>Insufici\u00eancia Renal Cr\u00f4nica com indica\u00e7\u00e3o para transplante renal.<\/li><li>Na preven\u00e7\u00e3o de transmiss\u00e3o de CMV em:<br \/>&#8211; Paciente HIV positivo com sorologia CMV negativa.<br \/>&#8211; Candidato a transplante de \u00f3rg\u00e3os e medula \u00f3ssea se doador e receptor forem CMV negativos.<br \/>&#8211; Transfus\u00e3o intrauterina.\u00a0<br \/>&#8211; Gestantes com sorologia n\u00e3o-reativa ou desconhecida para CMV.\u00a0<br \/>&#8211; Rec\u00e9m-nascidos prematuros e de baixo peso (1.200g) de m\u00e3es CMV negativas ou com sorologia desconhecida.<\/li><\/ul><p><strong>Irradia\u00e7\u00e3o:<\/strong><\/p><p>Procedimento realizado atrav\u00e9s da exposi\u00e7\u00e3o dos hemocomponentes celulares \u00e0 irradia\u00e7\u00e3o gama na dose de 2500cGy (25Gy), impossibilitando a multiplica\u00e7\u00e3o dos linf\u00f3citos.\u00a0A irradia\u00e7\u00e3o dos hemocomponentes \u00e9 realizada para a preven\u00e7\u00e3o da doen\u00e7a do enxerto versus hospedeiro associada \u00e0 transfus\u00e3o (DECH-AT), rea\u00e7\u00e3o transfusional tardia\u00a0imunol\u00f3gica, usualmente fatal, causada pelos linf\u00f3citos do doador em receptores suscet\u00edveis. Quando realizado em equipamento espec\u00edfico para irradia\u00e7\u00e3o celular apresenta maior efic\u00e1cia do que em equipamentos de acelera\u00e7\u00e3o linear. A irradia\u00e7\u00e3o altera o tempo de validade das hem\u00e1cias para 28 dias. As plaquetas n\u00e3o t\u00eam sua validade alterada pela irradia\u00e7\u00e3o.<\/p><p>Principais indica\u00e7\u00f5es da irradia\u00e7\u00e3o:<\/p><ul><li>Transfus\u00e3o intra-uterina.\u00a0<\/li><li>Exsangu\u00edneo-transfus\u00e3o, obrigatoriamente, quando houver transfus\u00e3o intra-uterina pr\u00e9via.<\/li><li>Rec\u00e9m-nascidos prematuros (inferior a 28 semanas) e\/ou de baixo peso (1.200g).<\/li><li>Portadores de imunodefici\u00eancias cong\u00eanitas graves.<\/li><li>P\u00f3s transplante de medula \u00f3ssea aut\u00f3logo ou alog\u00eanico.<\/li><li>P\u00f3s transplante com c\u00e9lulas de cord\u00e3o umbilical.<\/li><li>Pacientes tratados com an\u00e1logos da purina, fludarabina, cladribine, deoxicoformicina.<\/li><li>Receptor de transplante de cora\u00e7\u00e3o ou pulm\u00e3o.<\/li><li>Portadores de linfomas, leucemia miel\u00f3ide aguda e anemia apl\u00e1stica em uso de imunossupressor.<\/li><li>Receptor de concentrado de plaquetas HLA compat\u00edveis.<\/li><li>Quando o receptor e doador apresentarem algum grau de parentesco (filhos, pais, irm\u00e3os, tios, primos).<\/li><\/ul><p><strong>Lavagem:\u00a0<\/strong><\/p><p>Procedimento obtido atrav\u00e9s da suspens\u00e3o de hem\u00e1cias e plaquetas com solu\u00e7\u00e3o isot\u00f4nica de cloreto de s\u00f3dio est\u00e9ril em quantidade suficiente (1 a 3 litros) para eliminar a maior quantidade poss\u00edvel de plasma (prote\u00ednas totais &lt; 500 mg\/U). \u00c9 realizada em sistema aberto, em capela de fluxo laminar, em ciclos sucessivos de centrifuga\u00e7\u00e3o do componente e retirada do sobrenadante. Os concentrados de plaquetas lavados t\u00eam validade de 4 horas ap\u00f3s o procedimento em virtude do risco de contamina\u00e7\u00e3o bacteriana (sistema aberto).\u00a0<\/p><p>Principais indica\u00e7\u00f5es:<\/p><ul><li>Pacientes com defici\u00eancia de IgA e hist\u00f3ria de rea\u00e7\u00e3o anafil\u00e1tica em transfus\u00f5es anteriores.<\/li><li>Rea\u00e7\u00f5es al\u00e9rgicas graves.<\/li><\/ul><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-55010\" class=\"elementor-tab-title\" data-tab=\"10\" role=\"button\" aria-controls=\"elementor-tab-content-55010\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Compatibilidade<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-55010\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"10\" role=\"region\" aria-labelledby=\"elementor-tab-title-55010\"><p>A transfus\u00e3o de CP n\u00e3o necessita da realiza\u00e7\u00e3o pr\u00e9via de prova de compatibilidade.<\/p><p><b>Compatibilidade ABO:<br \/><\/b>Usar preferencialmente Concentrado de Plaquetas ABO id\u00eantico ao paciente. Entretanto, na indisponibilidade de componente id\u00eantico, podem ser usadas plaquetas de qualquer grupo ABO. O cuidado maior que devemos ter \u00e9 na transfus\u00e3o de plaquetas em crian\u00e7as com incompatibilidade ABO do plasma do doador com as hem\u00e1cias do receptor. Veja mais detalhes em Selecionando o concentrado de plaquetas.<\/p><p><b>Compatibilidade RhD:<br \/><\/b>Plaquetas RhD negativo devem ser reservadas para crian\u00e7as e mulheres com menos de 50 anos RhD negativo. Se plaquetas RhD positivo forem transfundidas nessas pacientes, deve-se administrar uma dose de 250UI de imunoglobulina anti-D para prevenir a forma\u00e7\u00e3o de anticorpo anti-D e evitar o risco de uma doen\u00e7a hemol\u00edtica perinatal futura. Essa dose \u00e9 suficiente para 5 transfus\u00f5es de plaquetas RhD positivo em at\u00e9 6 semanas ou at\u00e9 que haja o desaparecimento do anti-D passivo.<\/p><p><strong>Lembre: compat\u00edvel n\u00e3o \u00e9 igual!<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-55011\" class=\"elementor-tab-title\" data-tab=\"11\" role=\"button\" aria-controls=\"elementor-tab-content-55011\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dicas do EducaSangue<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-55011\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"11\" role=\"region\" aria-labelledby=\"elementor-tab-title-55011\"><p>Conhe\u00e7a as dicas do\u00a0<a href=\"https:\/\/preservasangue.com.br\/index.php\/educasangue\/\">EducaSangue<\/a>\u00a0sobre transfus\u00e3o de plaquetas e aprenda de forma r\u00e1pida e divertida como indicar e prescrever esse componente.\u00a0<br \/>Existem muitas particularidades que voc\u00ea precisa conhecer.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-ef2283c elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"ef2283c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-burn\"><\/i><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-be8490e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"be8490e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8eee1ca\" data-id=\"8eee1ca\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-5100aac elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5100aac\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-92ea509\" data-id=\"92ea509\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-24af111 elementor-widget elementor-widget-menu-anchor\" data-id=\"24af111\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"pfc\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ec6e845 elementor-widget elementor-widget-image\" data-id=\"ec6e845\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"118\" height=\"150\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2019\/04\/BOLSA3.png\" class=\"attachment-thumbnail size-thumbnail wp-image-766\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Plasma Fresco Congelado - PFC<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-085902e elementor-widget elementor-widget-text-editor\" data-id=\"085902e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Volume:<\/strong>\u00a0 &gt; 180mL<br \/><strong>Armazenamento:<\/strong> temperaturas inferiores a 20\u00baC ou 30\u00ba negativos.<br \/><strong>Validade:\u00a0<\/strong>\u00a0um ou dois anos se armazenado a 20\u00baC ou 30\u00baC negativos, respectivamente.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-b747c8a\" data-id=\"b747c8a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-57b0c3d elementor-widget elementor-widget-toggle\" data-id=\"57b0c3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9191\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-9191\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Caracter\u00edsticas e conte\u00fado<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9191\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-9191\"><p>Obtido por centrifuga\u00e7\u00e3o do sangue total doado e congelado completamente em at\u00e9 8 horas (PFC) ou 24 horas (PFC24) depois da coleta do sangue. Cont\u00e9m fatores de coagula\u00e7\u00e3o (V, VII e IX) e fibrinog\u00eanio. Deve ser descongelado a 37\u00baC antes da transfus\u00e3o no m\u00e1ximo 24 horas antes da infus\u00e3o se mantido \u00e0 temperatura de 2 a 6\u00baC. N\u00e3o pode ser recongelado.<\/p><p><strong>O plasma comum n\u00e3o tem indica\u00e7\u00e3o transfusional.<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9192\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"button\" aria-controls=\"elementor-tab-content-9192\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Uso justificado<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9192\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"region\" aria-labelledby=\"elementor-tab-title-9192\"><p>Deve ser transfundido apenas em pacientes nos quais os benef\u00edcios s\u00e3o maiores que os riscos associados \u00e0 transfus\u00e3o, ou seja,\u00a0 pacientes com sangramento e altera\u00e7\u00f5es do coagulograma ou\u00a0 que apresentam altera\u00e7\u00e3o do coagulograma, sem causa trat\u00e1vel e ser\u00e3o submetidos a procedimento cir\u00fargico. N\u00e3o h\u00e1 indica\u00e7\u00e3o de transfus\u00e3o de plasma em pacientes sem altera\u00e7\u00e3o de TAP ou TTPa.<\/p><p><strong>Situa\u00e7\u00f5es em que est\u00e1 justificado o uso do plasma:<\/strong><\/p><p>1. Hepatopatia com sangramento ativo grave e coagulograma e TAP alargado.<br \/>2. Coagula\u00e7\u00e3o intravascular disseminada em vig\u00eancia de sangramento ativo. O tratamento do fator desencadeante do dist\u00farbio \u00e9 a abordagem principal para controle do quadro.<br \/>3. Sangramento grave causado por uso de anticoagulantes orais (varfarina) ou necessidade de revers\u00e3o urgente da anticoagula\u00e7\u00e3o para realiza\u00e7\u00e3o de procedimentos. O uso do Complexo Protromb\u00ednico, sempre que dispon\u00edvel, \u00e9 prefer\u00edvel ao plasma, por apresentar menor risco de transmiss\u00e3o de v\u00edrus e grande efic\u00e1cia na revers\u00e3o da anticoagula\u00e7\u00e3o com volumes menores.<br \/>4. Hemorragia grave em uma propor\u00e7\u00e3o 1:1 com Concentrado de Hem\u00e1cias.<br \/>5. Edema angioneur\u00f3tico recidivante (Edema de Quincke) causado por d\u00e9ficit de inibidor de C1q-esterase.<br \/>6. P\u00farpura trombocitop\u00eanica tromb\u00f3tica (PTT) em regime de troca plasm\u00e1tica.<\/p><p><strong>Uso de plasma antes de procedimentos invasivos em pacientes com altera\u00e7\u00e3o da coagula\u00e7\u00e3o:<\/strong><\/p><p>Essa \u00e9 uma indica\u00e7\u00e3o que pode ser considerada adequada, embora\u00a0 a utiliza\u00e7\u00e3o de t\u00e9cnica cir\u00fargica cuidadosa realizada por profissional experiente na realiza\u00e7\u00e3o do procedimento seja o principal fator para prevenir complica\u00e7\u00f5es hemorr\u00e1gicas.<\/p><p><strong>Em pacientes com INR &lt;3 antes de pequenos procedimentos cir\u00fargicos (acesso central, traqueostomia, drenagem de t\u00f3rax e de abcessos) n\u00e3o traz benef\u00edcios e\u00a0 aumenta complica\u00e7\u00f5es.<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9193\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"button\" aria-controls=\"elementor-tab-content-9193\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Uso n\u00e3o justificado<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9193\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"region\" aria-labelledby=\"elementor-tab-title-9193\"><p><b>Situa\u00e7\u00f5es em que n\u00e3o est\u00e1 justificado o uso do Plasma:<\/b><\/p><p>&#8211; Uso com \u00fanico objetivo de expandir volume.<br \/>&#8211; Em sangramento sem coagulopatia.<br \/>&#8211; Para corre\u00e7\u00e3o de testes anormais da coagula\u00e7\u00e3o na aus\u00eancia\u00a0 \u00a0 \u00a0 de sangramento.<br \/>&#8211; Em estados de perda proteica e imunodefici\u00eancia.<br \/>&#8211; Septicemias<br \/>&#8211; Complemento de nutri\u00e7\u00e3o parenteral<br \/>&#8211; Tratamento de desnutri\u00e7\u00e3o<br \/>&#8211; Melhoria da cicatriza\u00e7\u00e3o<br \/>&#8211; Fonte de imunoglobulina<br \/>&#8211; Reposi\u00e7\u00e3o em sangrias terap\u00eauticas.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9194\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"button\" aria-controls=\"elementor-tab-content-9194\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Prescri\u00e7\u00e3o<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9194\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"region\" aria-labelledby=\"elementor-tab-title-9194\"><p>Cada unidade de plasma deve ser infundida em no m\u00e1ximo 4 hora.<br \/>Antes de ser utilizado o plasma deve ser completamente descongelado a 37\u00b0C em banho-maria ou equipamento apropriado e exclusivo para esse fim.<br \/>Depois de descongelado o plasma deve ser usado o mais rapidamente poss\u00edvel e n\u00e3o exceder 24 horas se mantido em refrigera\u00e7\u00e3o (2-6\u00b0C).\u00a0<br \/>N\u00e3o pode ser recongelado.<br \/>\u00c9 obrigat\u00f3rio o uso de equipo de transfus\u00e3o com dupla c\u00e2mara e filtro para macroagregados (200\u03bc).<\/p><p><strong>Cuidado! Plasma expande volume!<br \/><\/strong>A velocidade de infus\u00e3o deve ser avaliada de acordo com a situa\u00e7\u00e3o cl\u00ednica do paciente.\u00a0<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9195\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"button\" aria-controls=\"elementor-tab-content-9195\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dose<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9195\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"region\" aria-labelledby=\"elementor-tab-title-9195\"><p>A dose de ataque deve ser de 10-20mL de plasma\/Kg para obter eleva\u00e7\u00e3o de\u00a0 20% a 30% nos n\u00edveis dos fatores de coagula\u00e7\u00e3o do paciente e chegar a n\u00edveis hemost\u00e1ticos.<\/p><p>O controle do sangramento deve ser considerado como par\u00e2metro para parada da reposi\u00e7\u00e3o de plasma.<\/p><p>Quando utilizado para corre\u00e7\u00e3o de defici\u00eancias de fatores isolados da coagula\u00e7\u00e3o (V ou XI, por exemplo), a dose deve considerar o objetivo da reposi\u00e7\u00e3o, a meia-vida do fator reposto, e o n\u00edvel basal do fator no paciente, para definir o intervalo entre as doses.<\/p><p>Considerar as propriedades de expans\u00e3o de volume do plasma como um fator desencadeante de sobrecarga vol\u00eamica quando a infus\u00e3o de grandes volumes \u00e9 realizada. Nesses casos, \u00e9 necess\u00e1rio o monitoramento rigoroso do paciente para evitar desencadeamento de complica\u00e7\u00f5es card\u00edacas e respirat\u00f3rias.<\/p><p>Em neonatos e crian\u00e7as a dose recomendada \u00e9 10-20 mL\/kg<\/p><p><b>Lembre-se: Plasma expande volume! Voc\u00ea n\u00e3o usa para isso, mas esse efeito colateral n\u00e3o pode ser menosprezado!<\/b><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9196\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"button\" aria-controls=\"elementor-tab-content-9196\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Desleucocita\u00e7\u00e3o, irradia\u00e7\u00e3o e outros<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9196\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"region\" aria-labelledby=\"elementor-tab-title-9196\"><p>N\u00e3o se aplica<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9197\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"button\" aria-controls=\"elementor-tab-content-9197\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Compatibilidade<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9197\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"region\" aria-labelledby=\"elementor-tab-title-9197\"><p>N\u00e3o \u00e9 necess\u00e1rio realizar prova de compatibilidade antes da transfus\u00e3o de plasma.<\/p><p><b>Compatibilidade ABO:<br \/><\/b>A compatibilidade para o sistema ABO deve ser sempre respeitada, mas n\u00e3o \u00e9 preciso transfundir componentes de grupo id\u00eantico ao do receptor.<br \/>Paciente do grupo A pode receber plasma do grupo A e AB<br \/>Paciente do grupo B pode receber plasma do grupo B e AB<br \/>Paciente do grupo O pode receber plasma do grupo A, B, AB e O<br \/>Paciente do grupo AB pode receber plasma do grupo AB<\/p><p style=\"margin-bottom: 8px; text-overflow: ellipsis; overflow-wrap: break-word; color: #17394d; font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: #7a7a7a; font-family: Roboto, sans-serif; font-size: 1rem;\"><b>Compatibilidade\u00a0 RhD e para outros sistemas:<br \/><\/b>O sistema Rh e outros sistemas de grupos sangu\u00edneos n\u00e3o devem ser considerados.<\/span><\/p><p><strong>Lembre-se: compat\u00edvel n\u00e3o \u00e9 igual!<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-9198\" class=\"elementor-tab-title\" data-tab=\"8\" role=\"button\" aria-controls=\"elementor-tab-content-9198\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dicas do EducaSangue<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-9198\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"8\" role=\"region\" aria-labelledby=\"elementor-tab-title-9198\"><p>Conhe\u00e7a as dicas do <a href=\"https:\/\/preservasangue.com.br\/index.php\/educasangue\/\">EducaSangue<\/a> sobre a transfus\u00e3o de plasma. Esse \u00e9 um componente que apresenta indica\u00e7\u00f5es associadas a defici\u00eancia de fatores da coagula\u00e7\u00e3o e tem um potencial para desenvolvimento de rea\u00e7\u00f5es adversas associada a sua capacidade de expandir volume. N\u00e3o deixe de ver!<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-7628cf2 elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"7628cf2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-burn\"><\/i><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c4a1038 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c4a1038\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c4639ae\" data-id=\"c4639ae\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-9c8c053 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9c8c053\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-c4721d3\" data-id=\"c4721d3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0585c6b elementor-widget elementor-widget-menu-anchor\" data-id=\"0585c6b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"crio\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-06a456b elementor-widget elementor-widget-image\" data-id=\"06a456b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"119\" height=\"150\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2019\/04\/BOLSA4.png\" class=\"attachment-thumbnail size-thumbnail wp-image-767\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Crioprecipitado - CRIO<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-180bd7b elementor-widget elementor-widget-text-editor\" data-id=\"180bd7b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>Volume: <\/b>10 a 40 mL <br \/><b>Armazenamento:<\/b>\u00a0<span style=\"font-size: 1rem;\">temperaturas inferiores a 20\u00baC ou 30\u00ba negativos.<br \/><\/span><span style=\"font-weight: bold;\">Validade:\u00a0<\/span>\u00a0um ou dois anos se armazenado a 20\u00baC ou 30\u00baC negativos, respectivamente.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-8403bd3\" data-id=\"8403bd3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b80c744 elementor-widget elementor-widget-toggle\" data-id=\"b80c744\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1921\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-1921\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Caracter\u00edsticas e conte\u00fado<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1921\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-1921\"><p>O<span style=\"font-size: 1rem;\">btido a partir do descongelamento de uma unidade de plasma fresco congelado em temperatura entre 2\u00b0C e 6\u00b0C, remo\u00e7\u00e3o do plasma sobrenadante e recongelamento da prote\u00edna precipitada em intervalo de 1 hora.\u00a0<\/span><span style=\"font-size: 1rem;\">Cont\u00e9m glicoprote\u00ednas de alto peso molecular principalmente fator VIII, fator de Von Willebrand (FvW), fator XIII, fibrinog\u00eanio e fibronectina e se constitui na principal fonte de fibrinog\u00eanio para transfus\u00e3o.\u00a0<\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1922\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"button\" aria-controls=\"elementor-tab-content-1922\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Indica\u00e7\u00f5es<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1922\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"region\" aria-labelledby=\"elementor-tab-title-1922\"><p>O crioprecipitado \u00e9 a principal fonte transfusional de fibrinog\u00eanio. N\u00e3o deve ser usado para repor Fator VIII da coagula\u00e7\u00e3o.<\/p><p><span style=\"font-weight: bold;\">Situa\u00e7\u00f5es em que est\u00e1 justificado o uso do crioprecipitado:<\/span><\/p><p>1. Reposi\u00e7\u00e3o de fibrinog\u00eanio em pacientes com hemorragia por hipofibrinogenemia cong\u00eanita ou adquirida (&lt;100mg\/dL), disfibrinogenemia ou defici\u00eancia de fator XIII. As situa\u00e7\u00f5es cl\u00ednicas que podem estar associadas com hipofibrinogenemia adquirida s\u00e3o coagula\u00e7\u00e3o intravascular disseminada (CID), coagulopatia da transfus\u00e3o maci\u00e7a ou como complica\u00e7\u00e3o de tratamento trombol\u00edtico.<br \/>2. Reposi\u00e7\u00e3o de fator XIII da coagula\u00e7\u00e3o em pacientes com defici\u00eancia cong\u00eanita e sangramento.<br \/><span style=\"font-size: 1rem;\">3. Manuten\u00e7\u00e3o de fibrinog\u00eanio acima de 150mg\/dL em pacientes portadores de Leucemia Promieloc\u00edtica Aguda (LMA-M3) e na Hemorragia Grave.<\/span><\/p><p><span style=\"font-weight: bold;\">Situa\u00e7\u00f5es em que est\u00e1 justificado o uso do crioprecipitado:<\/span><span style=\"font-size: 1rem;\"><br \/><\/span><span style=\"font-size: 1rem;\">4. Nos pacientes que est\u00e3o fazendo uso de L-asparaginase e com hipofibrinogenemia est\u00e1 CONTRAINDICADO o uso de crioprecipitado pelo risco de maior n\u00famero de eventos tromb\u00f3ticos. Nessa situa\u00e7\u00e3o o uso de plasma deve ser considerado na presen\u00e7a de sangramento grave com risco de vida.\u00a0<\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1923\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"button\" aria-controls=\"elementor-tab-content-1923\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Contra-indica\u00e7\u00f5es<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1923\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"region\" aria-labelledby=\"elementor-tab-title-1923\"><p><b>Situa\u00e7\u00f5es em que est\u00e1 contra-indicado o uso do crioprecipitado:<\/b><\/p><p>1. Pacientes em uso de L-asparaginase e com hipofibrinogenemia (uso de crioprecipitado est\u00e1 associado a maior risco de eventos tromb\u00f3ticos). Nesses pacientes considerar uso de plasma na presen\u00e7a de sangramento grave com risco de vida.\u00a0<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1924\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"button\" aria-controls=\"elementor-tab-content-1924\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Prescri\u00e7\u00e3o<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1924\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"region\" aria-labelledby=\"elementor-tab-title-1924\"><p>Cada unidade deve ser infundida rapidamente, com equipo aberto.<br \/><span style=\"font-size: 1rem;\">Antes de ser utilizado o crioprecipitado deve ser completamente descongelado a 37\u00b0C em banho-maria ou equipamento apropriado e exclusivo para esse fim.<br \/><\/span><span style=\"font-size: 1rem;\">Depois de descongelado, deve ser usado o mais rapidamente poss\u00edvel ou mantido \u00e0 temperatura de 20 a 24\u00baC at\u00e9 no m\u00e1ximo 6 horas.<br \/><\/span><span style=\"font-size: 1rem;\">N\u00e3o pode ser recongelado.<br \/><\/span><span style=\"font-size: 1rem;\">\u00c9 obrigat\u00f3rio o uso de equipo de transfus\u00e3o com dupla c\u00e2mara e filtro para macroagregados (200<\/span><span style=\"font-size: 1rem;\">\u03bc<\/span><span style=\"font-size: 1rem;\">).<\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1925\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"button\" aria-controls=\"elementor-tab-content-1925\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dose<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1925\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"region\" aria-labelledby=\"elementor-tab-title-1925\"><ul><li style=\"list-style-type: none;\"><ul><li>Na hipofibrinogenemia (fibrinog\u00eanio &lt;100mg\/dL): grosseiramente pode-se utilizar 1 unidade a cada 7 kg. Cada unidade aumentar\u00e1 o fibrinog\u00eanio em 5-10mg\/dL em adulto m\u00e9dio, na aus\u00eancia de grandes sangramentos ou de consumo excessivo.<br \/>Em pacientes com hipofibrinogenemia grave e sangramento importante, a dose do crioprecipitado deve ser calculada conforme sequ\u00eancia a seguir:<br \/>Defina a volemia:\u00a0<br \/>Peso (kg) x 70 ml\/kg = volume sangu\u00edneo (mL)<br \/>Defina o volume plasm\u00e1tico:\u00a0<br \/>Volume sangu\u00edneo (mL) x (1,0 \u2013 hemat\u00f3crito) = volume plasm\u00e1tico (mL)<br \/>Defina a quantidade de fibrinog\u00eanio que voc\u00ea precisa repor:<br \/>mg de fibrinog\u00eanio desejado = [n\u00edvel de fibrinog\u00eanio desejado (mg\/dL)] \u2013 fibrinog\u00eanio inicial (mg\/dL) x volume plasm\u00e1tico (ml)\/ 100 ml\/dL.<\/li><li>Defina a quantidade de bolsas necess\u00e1rias para fazer a reposi\u00e7\u00e3o de fibrinog\u00eanio que voc\u00ea deseja: N\u00famero de bolsas necess\u00e1rias = mg de fibrinog\u00eanio desejado dividido por 250mg de fibrinog\u00eanio\/bolsa.<\/li><\/ul><\/li><\/ul><p><em>Quer uma ajuda no c\u00e1lculo? Baixe o app do Educasangue!<\/em><\/p><ul><li style=\"list-style-type: none;\"><ul><li>Na defici\u00eancia de fator XIII: 01 unidade a cada 10 kg com intervalo de 7 a 14 dias.<\/li><li>Em neonatos e crian\u00e7as a dose recomendada \u00e9 10 mL\/kg<\/li><\/ul><\/li><\/ul><p style=\"margin-bottom: 8px; text-overflow: ellipsis; overflow-wrap: break-word; color: #17394d; font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 14px;\">\u00a0<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1926\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"button\" aria-controls=\"elementor-tab-content-1926\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Desleucocita\u00e7\u00e3o, irradia\u00e7\u00e3o e outros<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1926\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"region\" aria-labelledby=\"elementor-tab-title-1926\"><p>N\u00e3o se aplica<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1927\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"button\" aria-controls=\"elementor-tab-content-1927\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Compatibilidade<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1927\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"region\" aria-labelledby=\"elementor-tab-title-1927\"><p>N\u00e3o \u00e9 necess\u00e1rio realizar prova de compatibilidade antes da transfus\u00e3o de Crioprecipitado.<\/p><p><b>Compatibilidade ABO:<br \/><\/b>Os componentes devem ser ABO compat\u00edveis (mesma compatibilidade do plasma) em crian\u00e7as com peso abaixo de 35 kg, mas n\u00e3o necessariamente id\u00eanticos.<\/p><p><b>Compatibilidade RhD e outros sistemas:<\/b><br \/>O sistema Rh e outros sistemas de grupos sangu\u00edneos n\u00e3o devem ser considerados.<\/p><p><strong>Lembre-se: Compat\u00edvel n\u00e3o \u00e9 igual!<\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1928\" class=\"elementor-tab-title\" data-tab=\"8\" role=\"button\" aria-controls=\"elementor-tab-content-1928\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Dicas do EducaSangue<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1928\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"8\" role=\"region\" aria-labelledby=\"elementor-tab-title-1928\"><p>A transfus\u00e3o de Crioprecipitado acontece em situa\u00e7\u00f5es bastante espec\u00edficas e restritas\u00a0 e o c\u00e1lculo da dose muitas vezes pode representar um desafio.<br \/>Veja as dicas preparadas pela equipe do <a href=\"https:\/\/preservasangue.com.br\/index.php\/educasangue\/\">EducaSangue<\/a>. Elas v\u00e3o ajudar voc\u00ea a usar melhor esse componente.\u00a0<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-85e8ef7 elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"85e8ef7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-burn\"><\/i><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6afb1b1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6afb1b1\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7b6b908\" data-id=\"7b6b908\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-77a442c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"77a442c\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-0928665\" data-id=\"0928665\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-de84f67 elementor-widget elementor-widget-image\" data-id=\"de84f67\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/educasangue.com.br\/index.php\/procedimento-de-transfusao\/\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2019\/10\/patient-1.png\" class=\"elementor-animation-shrink attachment-thumbnail size-thumbnail wp-image-2785\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-inner-column elementor-element elementor-element-ecbf776\" data-id=\"ecbf776\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3b2b9a8 elementor-widget elementor-widget-heading\" data-id=\"3b2b9a8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">E agora, que tal saber como fazer a transfus\u00e3o?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-265dedc elementor-widget elementor-widget-text-editor\" data-id=\"265dedc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Veja o que voc\u00ea sempre quis saber sobre o procedimento de transfus\u00e3o e responda suas d\u00favidas sobre velocidade e tempo de infus\u00e3o, uso de equipos, medicamentos e solu\u00e7\u00f5es concomitantes, acesso venoso e mais informa\u00e7\u00f5es que consideramos \u00fateis para que seu paciente tenha a maior seguran\u00e7a poss\u00edvel durante e ap\u00f3s a transfus\u00e3o!<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-73c2f0c elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"73c2f0c\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-60acc04\" data-id=\"60acc04\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7082e8c elementor-widget-divider--view-line_icon elementor-view-default elementor-widget-divider--element-align-center elementor-widget elementor-widget-divider\" data-id=\"7082e8c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon elementor-divider__element\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-burn\"><\/i><\/div>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-296fa2a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"296fa2a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-fe624a0\" data-id=\"fe624a0\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-33d39bc\" data-id=\"33d39bc\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b07b3a elementor-widget elementor-widget-heading\" data-id=\"1b07b3a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Baixe nosso aplicativo<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-2309141 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2309141\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-5e7b58c\" data-id=\"5e7b58c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c6834f7 elementor-widget elementor-widget-image\" data-id=\"c6834f7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/play.google.com\/store\/apps\/details?id=com.educasangue&#038;hl=pt-BR\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"215\" height=\"71\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/12\/v11_google_play.png\" class=\"attachment-full size-full wp-image-4523\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-798d91c\" data-id=\"798d91c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2b4b0f2 elementor-widget elementor-widget-image\" data-id=\"2b4b0f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/apps.apple.com\/us\/app\/educasangue\/id1530396042\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"215\" height=\"71\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/12\/v11_app_store.png\" class=\"attachment-full size-full wp-image-4524\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-04ecb2a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"04ecb2a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-7dd622a\" data-id=\"7dd622a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-aa13c7a elementor-widget elementor-widget-image\" data-id=\"aa13c7a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/elementskit.xpeedstudio.com\/\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1700\" height=\"394\" src=\"https:\/\/educasangue.com.br\/wp-content\/uploads\/2020\/07\/LOGO-EDUCASANGUE-PRESERVA.png\" class=\"attachment-full size-full wp-image-3223\" alt=\"\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7999e75 elementor-widget elementor-widget-elementskit-social-media\" data-id=\"7999e75\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-social-media.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" >\t\t\t <ul class=\"ekit_social_media\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<li class=\"elementor-repeater-item-da8f4de\">\n\t\t\t\t\t    <a\n\t\t\t\t\t\thref=\"https:\/\/m.facebook.com\/educasangue1\" aria-label=\"Facebook\" class=\"facebook\" >\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"icon icon-facebook\"><\/i>\n                                                                                                            <\/a>\n                    <\/li>\n                    \t\t\t\t\t\t\t\t\t\t\t\t\t\t<li class=\"elementor-repeater-item-c8596be\">\n\t\t\t\t\t    <a\n\t\t\t\t\t\thref=\"#\" aria-label=\"Instagram\" class=\"2\" >\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"icon icon-instagram-2\"><\/i>\n                                                                                                            <\/a>\n                    <\/li>\n                    \t\t\t\t\t\t\t<\/ul>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5ece7f1 elementor-widget elementor-widget-text-editor\" data-id=\"5ece7f1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>O conte\u00fado deste site corresponde ao Manual de Uso Racional de Sangue\u00a0<br \/>DIRT GER 03<br \/>Centro de Hematologia e Hemoterapia do Cear\u00e1 &#8211; HEMOCE <br \/>2<a href=\"https:\/\/educasangue.com.br\/index.php\/versionamento\/\" target=\"_blank\" rel=\"noopener\">\u00aa Revis\u00e3o (08\/04\/2022)<\/a>.<\/p><p><span style=\"font-size: 10pt;\"><strong>Elaborado por: <\/strong>Luciana Carlos\u00a0 \u00a0 \u00a0<strong>Revisado por: <\/strong>Luany Mesquita\u00a0 \u00a0 \u00a0<strong>Aprovado por: <\/strong>Denise Brunetta<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b5b2e52 elementor-widget elementor-widget-text-editor\" data-id=\"b5b2e52\" data-element_type=\"widget\" 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PBM no Cear\u00e1 Transfus\u00e3o Quando transfundir Como evitar a transfus\u00e3o desnecess\u00e1ria Procedimento de transfus\u00e3o Suspeita de rea\u00e7\u00e3o transfusional Testes pr\u00e9-transfusionais Dicas Evid\u00eancias Download Fale conosco X Home sobre PBM O que \u00e9 PBM? PBM no Cear\u00e1 Transfus\u00e3o Quando transfundir testes pr\u00e9 transfusionais Procedimento de transfus\u00e3o Suspeita de rea\u00e7\u00e3o &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/educasangue.com.br\/index.php\/quando-transfundir\/\" class=\"more-link\">Continue lendo<span class=\"screen-reader-text\"> &#8220;Quando transfundir&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-398","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Quando transfundir - EducaSangue<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/educasangue.com.br\/index.php\/quando-transfundir\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Quando transfundir - EducaSangue\" \/>\n<meta property=\"og:description\" content=\"Home sobre PBM O que \u00e9 PBM? PBM no Cear\u00e1 Transfus\u00e3o Quando transfundir Como evitar a transfus\u00e3o desnecess\u00e1ria Procedimento de transfus\u00e3o Suspeita de rea\u00e7\u00e3o transfusional Testes pr\u00e9-transfusionais Dicas Evid\u00eancias Download Fale conosco X Home sobre PBM O que \u00e9 PBM? 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