title: Measuring the influence of blood component infusion rate on recipient vital signs.
abstract: OBJECTIVE
  One of the challenges surrounding blood component administration is the determination of an appropriate rate of infusion. There are very few evidence-based guidelines available to guide healthcare providers looking for a 'standard' infusion rate for red blood cells (RBCs), plasma or platelets (PLTs). Our objective was to determine the extent to which blood component infusion rates were associated with changes in transfusion recipient vital signs.
  
  
  METHODS
  We retrospectively examined records of 3496 component infusions (RBCs, n = 2359; PLTs, n = 478; plasma, n = 659) over a 1-year period at a 362-bed multispecialty hospital. The following data were collected for each transfusion: blood product volume and infusion time, recipient pre- and post-transfusion temperature, blood pressure and pulse rate, and hospital ward where transfusion occurred.
  
  
  RESULTS
  Plasma (median 10.4 ml/min) was infused faster than PLTs (median 7.2 ml/min, P < 0.0001) or RBCs (median 2.3 ml/min, P < 0.0001). For all blood components, infusion rates varied based on the hospital unit performing the infusion. No association was found between relatively fast RBC, plasma or PLT infusion rates (>20 ml/min) and clinically significant reported changes in vital signs.
  
  
  CONCLUSIONS
  There does not appear to be a strong correlation between infusion rate and significant changes in recipient temperature, blood pressure or pulse rate. Based on these data, a reasonable rate for routine transfusion is 2-3 ml/min for RBCs and 7-10 ml/min for plasma and PLTs. Faster infusion rates (>20 ml/min) likely can be applied with close patient monitoring if there is a more urgent need for transfusion.
authors.affiliation: Department of Laboratory Medicine, Yale University, New Haven, CT, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Gehrie
authors.affiliation: Department of Laboratory Medicine, Yale University, New Haven, CT, USA.|Department of Pediatrics, Yale University, New Haven, CT, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Hendrickson
authors.affiliation: Department of Laboratory Medicine, Yale University, New Haven, CT, USA.|Pathology & Laboratory Medicine Service, VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Tormey
mesh_terms: D016913:Blood Component Transfusion / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D055986:Vital Signs
keywords: blood components; blood safety; fresh frozen plasma; patient blood management; transfusion reactions