Term
| Platelets inside PRBC units lose function after how long ? |
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Definition
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Term
| 1 unit of PRBC will increase Hgb by ___ g/dl and hct by __% in the 70kg adult |
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Definition
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Term
| How many ml's per KG of PRBC would I want to give to raise the hgb by 3 g/dl? |
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Definition
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Term
| What factors that are found in FFP are labile? |
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Definition
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Term
| Name 4 instances where FFP is indicated? |
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Definition
1. liver disease
2. coumadin reversal
3. massive blood transfusions
4. Anti-thrombin III deficiencies |
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Term
| What is the lifespan of transfused platelets? |
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Definition
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Term
| True or Fasle: Platelets should be transfused using a 70 micron filter? |
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Definition
| False; no smaller than 170 micron or platelets will be removed by filter |
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Term
| At what fibrinogen level should cryoprecipitate be transfused? |
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Definition
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Term
| Cryoprecipitate contains what factors? |
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Definition
| Firbrinogen (factor I), VIIIc,VIII-vWF & XIII |
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Term
| What is the most common cause of acute hemoytic blood transfusion reactions? |
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Definition
MISIDENTIFICATION of patient, blood, specimen, or blood unit
(ABO incompatibility) |
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Term
| Hemoglobinuria is a symptom of what? |
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Definition
| Acute hemolytic transfusion reaction |
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Term
| In what time frame does delayed hemolytic reactions occur? |
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Definition
| 2-21 days after transfusion |
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Term
| Malaise, jaundice, and fever are symptoms of what type of transfusion reaction? |
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Definition
| delayted hemolytic reaction |
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Term
| What is the most common type of transfusion reaction? |
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Definition
| Nonhemolytic immune reactions: Febrile Type reactions |
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Term
| Patients with a history of Febrile type of Nonhemolytic immune reactions should recieve what type of transfusion? |
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Definition
| Leukocyte-poor transfusion |
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Term
| Erythema, hives and itching (without fever) are symptoms of what type of reaction? |
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Definition
| Uticarial non-hemolytic reactions |
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Term
| Antihistamines (H1) and H2 blockers are the primary treatment in what type of reaction? |
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Definition
| Uticarial non-hemolytic reactions |
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Term
| Treatment for Anaphylactic transfusion reactions (non-hemolytic) include? |
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Definition
Epineprhine
corticosteroids
H1&H2 blockers
Cardiovascular support |
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Term
| What symptoms occur in a pt under anesthesia who is having an anaphylactic transfusion reaction? |
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Definition
| hives, increased airway pressures, wheezing, decreased pulse ox, tachycardia |
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Term
| IgA free blood or washed cells should be given to pateints with what type of reaction hx? |
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Definition
| Anaphylactic transfusion reaction |
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Term
| Non-cardiogenic pulmonary edema is aka? and caused by? |
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Definition
| TRALI - transfusion related acute lung injury, d/t aggregation of white cells in pulmonary circulation |
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Term
| TRALI is similar to ARDS however it is differentiated by? |
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Definition
| duration, TRALI usually resolves in 12-48 hours |
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Term
| To avoid Graft vs Host reactions immunocompromised pts should recieve what type of blood? |
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Definition
| Irradiated blood (kills lymphocytes) |
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Term
| True or False; Filters effectively remove lymphocytes from blood products? |
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Definition
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Term
| Transfusion of leukocytes in blood products can cause? |
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Definition
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Term
| Patients recieving transfusions are at greatest risk for what type of infection? |
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Definition
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Term
| True or False; 50% of donors have been exposed and have CMV antibody presence |
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Definition
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Term
| What patients are at high risk for severe infectons related to CMV with transfusion? |
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Definition
| AIDS, bone marrow transplants, organ recipients, low birth weight neonates |
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Term
| Syphilis can be transmitted through what type of blood product? |
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Definition
| Platelets (stored @ room temp) |
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Term
| Contraction of Parvovirus from transfusions are significant in only this population? |
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Definition
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Term
| Dura mater grafts, corneal transplants, REUSE of EKG electrodes, and pituitary growth hormone injections can increase the risk for what type of infection? |
|
Definition
| Creutzfeldt-Jakob disease |
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Term
| Overall infection rates are highest with what type of product and why?? |
|
Definition
Contaminated platelets 1:12,000
Greater risk in pooled platelets
Death rate is high
Stored at room temperature |
|
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Term
| 7 changes in stored blood |
|
Definition
1. increased plasma potassium
2. Increased plasma ammonia
3. red cell lysis
4. increased Lactate levels
5. decreased pH (acidic)
6. decreased 2,3 DPG (shifts oxyhgb dissociation curve to the Left)
7. reduced RBC ATP levels |
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Term
| Citrate toxicity occurs with large volume of transfusions and results in what electrolyte abnormality? |
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Definition
| low serum ionized calcium level |
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|
Term
| List 3 major reasons to replace Calcium when citrate intoxication occurs? |
|
Definition
1. to improve inotropy
2. to decrease bleeding; blood clotting
3. for smooth muscle contraction; calcium calmodulin complexing- prevent vasodilaiton/hypotension |
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Term
| What is usually the cause of acidosis in patients who have received a blood transfusion? |
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Definition
| Usually due to poor perfusion, even though CPDA in blood decreses the pH, which falls even further after 21 days |
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Term
| Name 2 reasons why rapid blood transfusions should be placed on warmers? |
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Definition
| hypothermia (cold blood) & banked blood (reduced 2,3 DPG) both shift oxyhgb curve left |
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Term
| Transfusing PRBCs through a Central line will increase the risk for? |
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Definition
| Hyperkalemia (high pressure infusion through small bore catheter =cell lysis) |
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Term
| Hypothermia related to PRBC transfusion can cause? |
|
Definition
decreased CO
vasoconstriction
metabolic acidosis (left shift in oxyhbg curve & cessation of enzymatic reactions)
coagulapthy (plts and coagulation factors are dysfunctional at temp <34 C)
shivering on emergence (increases 02 consumption by 400%) |
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Term
| How would you differentiate dilutional coagulapthy from PRBC transfusion from DIC? (labs) |
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Definition
plts decreased in both,
but coag profile usually normal in dilutional coagulapthy. DIC will have increased PTT, PT, increased FSP |
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Term
| Name 2 ABSOLUTE contraindications to cell saver transfusion? |
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Definition
| malignancy & contamination |
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Term
| For every 300ml of cell saver how much will hgb increase? |
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Definition
| 1/2 g/dl (Hct is 45-50% in cell saver) |
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Term
| What are 2 major complications of ANH (acute normovolemic hemodiluation) ? |
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Definition
| myocardial ischemia and cerebral hypoxia |
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