1.4 Transfusion highlights Flashcards
1 unit of PRBC (packed RBCs) (250 mL) raises Hgb by how much?
“know this”
1 g/dL
Packed Red Blood Cell (PRBCs)
What assesses ABO/Rh blood type, the presence of antibodies, and patient and donor blood compatibility?
(~15 min to determine blood type, 45-60 minutes for serologic cross-match)
Type and cross-match
Packed Red Blood Cell (PRBCs)
In critical situations (e.g., no time to perform a complete ABO/Rh-typing), group _____________ blood (“universal donor”) can be given to patients without waiting for a complete type and cross-match
O/Rh-negative
Packed Red Blood Cell (PRBCs):
1) A ______________ strategy (e.g., Hgb <7-8 g/dL) is utilized for RBC transfusions in most patients versus higher (more liberal) transfusion thresholds.
2) What are 4 major exceptions to this?
1) restrictive
2) symptomatic patients, acute MI, massive transfusion* (trauma, serious GI bleeding), and chronic transfusion-dependent anemias (sickle cell disease, thalassemia)2
PRBCs:
1) Post-transfusion Hgb may be accurately measured as early as ______ minutes following transfusion
2) An _________ shows a strategy for most patients, but does not include all situations
1) 15
2) algorithm
Platelets:
1) What 2 forms are they available in?
2) 1 __________ platelet unit will increase the platelet count by up to 50,000/mm3.
3) May be used in thrombocytopenic pts to do what 2 things?
1) Whole blood derived (WBD) platelets or apheresis platelets
2) apheresis
3) prevent bleeding (prophylaxis) or to help stop active bleeding
PRBCs: What are some considerations for transfusions?
1) Symptoms
2) Clinical status
3) Underlying conditions
4) Hemoglobin level
5) Rate of hemoglobin decline and cause
When is RBC transfusion recommended for most pts?
<7g/ dL
Platelets can be lifesaving in ___________ patients with thrombocytopenia or reduced platelet function
bleeding
Prophylactic platelets:
1) For most hospitalized _______ patients with PLT counts __________/microL due to bone marrow suppression
2) Some individuals may require transfusion at higher platelet counts (fever, infection, or inflammation, generally transfuse at PLT _________________/microL due to the increased risk of bleeding)
1) afebrile; ≤10,000
2) ≤15,000-20,000
Platelet transfusions:
Platelet consumption disorders (including ITP, TTP, HIT, DIC, liver disease) and platelet function disorders:
Typically transfused only for _______________, or ____________ procedures
bleeding or selected invasive
What are the 3 main indications for platelet transfusions?
1) Bleeding
2) Prophylaxis
3) Platelet consumption disorders or platelet function disorders
Fresh Frozen Plasma (FFP):
1) What does it contain?
2) Used for replacement of multiple ___________ deficiencies (liver failure, warfarin-induced over-anticoagulation and massive transfusion) and to correct coagulation defects for which __________ is available.
1) all coagulation factors and fibrinogen
2) coagulation; no factor
Cryoprecipitate (derived from FFP):
1) It contains what factors?
1) VIII (8), von Willebrand, fibrinogen, factor XIII (13?), fibronectin
List 3 indications for cryoprecipitate
1) active bleeding in patients with afibrinogenemia or hypofibrinogenemia
2) active bleeding in patients with von Willebrand disease
3) hemophilia type A
Hemolytic transfusion Rxns:
1) Can be ______ (most severe) or _________ (less severe), related to the timing of the transfusion.
2) When does the most severe form happen? What happens with this condition?
1) acute; delayed
2) ABO incompatibility; rapid intravascular hemolysis
What are 2 of the main treatments for hemolytic transfusion Rxns?
1) Stop the transfusion immediately
2) Aggressively hydrate
List 3 Sx of hypersensitivity Rxns with transfusion
1) Urticaria or bronchospasm
2) anaphylactic shock
Transfusion Graft-Versus-Host Disease
Recipients at high risk can be given ____________ blood products (kills lymphocytes)
irradiated
Transfusion Graft-Versus-Host Disease:
Allogeneic passenger _____________ in transfused blood products engraft in some recipients and then mount an alloimmune attack against host tissues expressing discrepant HLA antigens
lymphocytes
