How to Order LPRC Transfusion (Also CPM) for Symptomatic Anemia in IPD Settings

In non-emergency IPD (inpatient department) settings, transfusion of Leukocyte-Poor Red Cells (LPRC) is commonly done for symptomatic anemia. This article walks you through the key indications, clinical considerations, and how to properly write a safe and complete transfusion order.

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🔍 Clinical Indications for LPRC Transfusion

LPRC transfusion is indicated when anemia becomes symptomatic or hemoglobin levels fall below safe thresholds. Symptoms can include:

• Fatigue, weakness

• Dizziness or syncope

• Shortness of breath (especially on exertion)

• Palpitations

• Pale conjunctiva or skin

• Postural hypotension

Typical Thresholds:

• Hb < 7 g/dL — Transfuse even if asymptomatic

• Hb < 8 g/dL — If symptomatic or has cardiovascular disease

• Hb < 9–10 g/dL — Special cases (perioperative, chemotherapy)
  

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🩺 Premedication Consideration

In patients with a history of minor transfusion reactions or to reduce risk of allergic responses, it’s common to give an antihistamine premedication like Chlorpheniramine Maleate (CPM).

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📝 Example Order Format for IPD

Doctor's Order (IPD - Symptomatic Anemia) Group match LPRC 1 unit ตามมาให้เลย (transfuse as soon as available) IV drip over 4 hours Hold IV fluid during blood transfusion Premedication: CPM 10 mg IV stat (administer slowly over 1–2 minutes)

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🧠 Clinical Tips:

• Do not exceed 4 hours per unit — increased risk of bacterial contamination.

• Monitor vitals pre-, intra-, and post-transfusion.

• Document transfusion reaction signs (e.g., chills, urticaria, back pain).

• Resume IV fluids after transfusion is complete if previously held.