138 Blood Procurement and Red Cell Transfusion Flashcards
Used for anticoagulation of blood products
Citrate
Sodium citrate, citric acid, and dextrose
Blood donors are more likely than the general population to be:
- Male
- Ages 30 to 50 years old
- White
- Employed
- Have more education
- Higher income
The additive solutions enable storage of RBCs for up to ___ days at __ to __C.
In addition to citrate and dextrose, adenine, mannitol, and phosphate
42 days
1 to 6 C
The actual time for collection of 450 to 500 mL usually is approximately ___ minutes
7 minutes
Almost always is less than 10 minutes
TRUE OR FALSE
During blood donation, cardiac output falls slightly but heart rate changes little. A slight decrease in systolic blood pressure results with a rise in peripheral resistance and diastolic blood pressure.
TRUE
During blood donation, cardiac output falls slightly but heart rate changes little.
A slight decrease in systolic blood pressure results with a rise in peripheral resistance and diastolic blood pressure.
Collected blood is mixed with ______ mL of anticoagulant composed of citrate, phosphate, and dextrose.
63 to 70 mL
An untoward reaction after blood donation occurs in approximately 2% to 5% of donors, but, fortunately, most of the reactions are not serious.
Donors who have reactions are more likely to be:
Donors who have reactions are more likely to be:
* Younger
* Unmarried
* Have a higher predonation heart rate and lower diastolic blood pressure
* Have a lower weight
* Female
* First-time or infrequent donors
The most common reactions to blood donation
Weakness, cool skin, and diaphoresis
Bradycardia usually is considered a sign of a vasovagal reaction rather than hypotensive or cardiovascular shock, where tachycardia would be expected.
Packed red cells has a final hematocrit of about _____%
80%
A unit of packed red cells has a volume of around ______mL and will contain about _____ mL of red cells
300 mL
190 mL of red cells
About ____ mL of plasma remains from the original unit of whole blood.
20 mL of plasma
The red cell component can be stored at 1 to 6 °C for up to ____ days
42 days
Plasma that is frozen within _____ hours of collection it is referred to as fresh frozen plasma (FFP) and contains essentially all of the hemostatic capacity of fresh plasma.
Eight hours
Plasma that is not frozen until about 24 hours after collection
Has some value in hemostasis but lacks all of the levels of coagulation factors found in FFP
Frozen plasma (FP)-24
Plasma products are stored at –18 °C or below for up to ______.
One year
TRUE OR FALSE
When platelets are prepared from whole blood, four or five units from whole blood are pooled to obtain a therapeutic dose of platelets.
TRUE
When platelets are prepared from whole blood, four or five units from whole blood are pooled to obtain a therapeutic dose of platelets.
Whole blood–derived platelets are stored at 20 to 24 oC, similar to apheresis platelets.
Established or Potential Adverse Effects of Leukocytes in Blood Component
Immunologic effects
- Alloimmunization
- Febrile nonhemolytic transfusion reactions
- Refractoriness to platelet transfusions
- Rejection of transplanted organs
- Graft-versus-host disease
- TRALI
Established or Potential Adverse Effects of Leukocytes in Blood Component
Immunomodulation
- Increased bacterial infections
- Increased recurrence of malignancy
Established or Potential Adverse Effects of Leukocytes in Blood Component
Infectious disease transmission
- CMV
- HTLV1
- EBV
CHE!
Autologous blood for transfusion can be obtained by
- Preoperative donation
- Acute normovolemic hemodilution
- Intraoperative salvage
- Postoperative salvage
Most commonly this situation occurs with elective surgery.
TRUE OR FALSE
No age or weight restrictions exist for autologous donation.
TRUE
No age or weight restrictions exist for autologous donation.
TRUE OR FALSE
Pregnant women can’t donate their own blood if they require transfusion.
FALSE
Pregnant women can donate, but this practice is not recommended because these patients rarely require transfusion.
Usually only ______ units of blood can be obtained before the Hb falls below 110 g/L
Hb may be lower (110 g/L) than that required for routine donors (125 g/L)
2 to 4 units
If the autologous donor does not meet the FDA criteria for blood donation, the blood must be specially labeled, segregated during storage, and discarded if it is not used by that specific patient.
Autologous blood donors can be given ________________to increase the number of units of blood they can donate
Erythropoietin and iron
Are friends or relatives who wish to give blood for a specific patient because the patient hopes those donors will be safer than the regular blood supply
Directed donors
Appropriate transfusion therapy involves collecting blood from a particular donor for a particular patient
Patient-specific donation
Patient-specific donation: donor may donate as often as every _____ days as long as the Hb remains above the normal donor minimum of ______ g/L.
3 days
125 g/L
An exception is donation of maternal platelets for a neonate with neonatal alloimmune thrombocytopenic purpura.
Blood can be collected as part of the therapy of diseases (therapeutic bleeding) such as
Polycythemia vera or primary hemochromatosis
Such blood is not used for transfusion because the donors do not meet the FDA standards for donor health.
Plateletpheresis results in a platelet concentrate with a volume of approximatel____mL and containing approximately _______platelets and less than 0.5 mL red cells.
Plateletpheresis requires approximately 90 minutes
250 mL
3.5 × 1011
Contains less than 5 × 106 leukocytes and thus can be considered leukocyte reduced.
After plateletpheresis, the donor’s platelet count declines by approximately ______% but returns to pre-plateletpheresis levels in approximately ______days.
30%
4 days
In red cell apheresis, because two units of red cells are removed, donors may donate only every _____ months
Every 4 months
Leukapheresis: procedure involves processing 6500 to 8000 mL of donor blood for approximately ___ hours
Because the efficiency of granulocyte extraction from whole blood is less than for platelets
Has been used to produce a granulocyte concentrate for transfusion therapy of infections unresponsive to antibiotics
3 hours
TRUE OR FALSE
Plasmapheresis is used to obtain plasma for manufacture of derivatives and plasma for transfusion.
FALSE
Plasmapheresis is used to obtain plasma for manufacture of derivatives but not plasma for transfusion.
- Plasmapheresis usually can be performed in approximately 30 minutes and produces up to 750 mL of plasma.
- Because few red cells are removed, the procedure can be repeated up to two times per week
Must knows during apheresis
- No more than 15% of the donor’s blood should be extracorporeal during apheresis; thus, the donor’s size is considered when making decisions about specific apheresis procedures or instruments to be used.
- The donor must not have taken aspirin for at least 3 days.
- The amount of blood components removed from apheresis donors must be monitored. Not more than 200 mL of red cells per 2 months or approximately 1500 mL of plasma per week can be removed.
The major side effect of hydroxyethyl starch
Blood volume expansion manifested by headache and/or hypertension
Apheresis donors experience a higher incidence of:
Paresthesias
Probably because of the infusion of citrate (that may affect calcium levels)
Managed by slowing the blood flow rate through the instrument
When granulocyte colony-stimulating factor and glucocorticoids are used in leukapheresis to obtain a granulocyte concentrate, approximately 60% of donors experience side effects:
Myalgia, arthralgia, headache, or flulike symptoms
