[25] CHAPTER X LESSON 3 Flashcards
is the donation of blood by the intended recipient.
Autologous (self) transfusion
The infusion of blood from another donor is called
allogeneic transfusion.
The patient’s own blood reduces the possibility of transfusion reaction or transmission of infectious disease
Autologous (self) transfusion
Collected by regular blood donation procedure, the blood can be stored as liquid or, for longer storage, frozen.
- Predeposit autologous donation
Usually reserved for patients anticipating a need for transfusion, such as for a scheduled surgery
- Predeposit autologous donation
Collection of 1 or 2 units of blood from the patient just before a surgical procedure, replacing the removed blood volume with crystalloid or colloid solution.
- Intraoperative hemodilution
Then, at the end of surgery, the blood units are infused into the patient.
- Intraoperative hemodilution
Group O RBCs are selected for patients for whom transfusion cannot wait until their ABO and Rh type can be determined.
- Emergency Transfusion
Group O-negative RBC units should be used if the patient is a female of child-bearing potential.
- Emergency Transfusion
After issuing O blood or type-specific blood, the antibody screen can be completed, and decisions can then be made for the selection of additional units of blood.
- Emergency Transfusion
Massive transfusion is defined as the replacement of one or more blood volumes within 24 hours, or about 10 units of blood in an adult.
- Massive Transfusion
Draw type and crossmatch
2 units group O RBCs uncrossmatched
Prepare massive transfusion protocol pack by transfusion service
4 to 6 type-specific or cross matched RBCs
4 plasma
1 platelet pool or plateletpheresis
Monitor CBC, platelet count, PT/INR, PTT, fibrinogen
Add or subtract components based on lab values
Provide additional MTP packs
Continue transfusion until unneeded
Premature infants frequently require transfusion of small amounts of RBCs to replace blood drawn for laboratory tests and to treat the anemia of prematurity
- Neonatal Transfusion
Neonatal Transfusion
A dose of [?] will increase the hemoglobin by approximately [?]
10 mL/kg
3 g/dL.
Neonatal Transfusion Aliquoted Units
Less than 7 days old, unless infused slowly
O-negative or compatible with mother and infant
CMV-negative or leukocyte-reduced
Hemoglobin S–negative for hypoxic newborns
Neonatal Transfusion Dose:
10 mL/kg over 2 to 3 hours
The patient identification label is compared at the bedside to the [?]. This prevents a specimen tube labeled with one patient’s name being used for the collection of a specimen from another patient.
patient’s hospital armband
The [?] are applied to the specimen tubes before leaving the bedside to avoid labeling the wrong tube.
labels
The AABB Standards states “Blood and blood components shall be transfused through a [?] that has a filter designed to retain particles potentially harmful to the recipient.”
sterile, pyrogen-free transfusion set
Blood components are infused slowly for the first [?] while the patient is observed closely for signs of a transfusion reaction.
10 to 15 minutes
The blood components should then be infused as quickly as tolerated or, at most, within [?].
4 hours
In standard blood administration sets, the [?] filter removes gross clots and cellular debris.
150- to 260-µm
A [?] must be used for transfusion of all blood components.
blood administration filter
• The receipt, preparation, and issue of blood components is guided by [?] published and enforced by the FDA.
current good manufacturing practice (cGMP) regulations
• Each blood product is prepared and stored to optimize its [?] at the time of transfusion.
purity and potency
• Quality control parameters are set by the [?].
FDA and AABB
Increases red cell mass and plasma volume
Whole blood
Whole blood Often available only for autologous units
Red Blood Cells (RBCs),
Apheresis RBCs
Increase oxygen-carrying capacity in anemia, trauma, and surgery
Expiration varies with anticoagulant
Frozen/deglycerolized RBCs
Prolonged red cell storage for rare blood units and autologous storage
24-hour outdate following deglycerolization
Washed RBCs
Reduce plasma proteins to avoid allergic and anaphylactic reactions (IgA deficiency)
24-hour expiration following washing
Platelets and RBCs Leukocyte
Reduced
Avoid febrile nonhemolytic reactions and prevent HLA alloimmunization, reduce
CMV transmission
Prestorage filtration more effective in avoiding cytokines
Irradiated RBCs and Platelets
Prevent GVHD in
immunocompromised patients, HLA-matched platelets or transfusions from a blood relative
Irradiation decreases shelf life of RBCs to 28 days
Platelets, Pooled Platelets
Bleeding caused by thrombocytopenia or thrombocytopathy
Pooling reduces expiration to 4
hours
Apheresis Platelets
Bleeding caused by thrombocytopenia or thrombocytopathy
May be HLA matched with recipient in cases of refractoriness
FFP, PF24
Replace stable and labile coagulation factors
Used in surgeries, trauma, and some factor deficiencies
Cryoprecipitated AHF (CRYO)
Contains fibrinogen, factors XIII and VIII, and von Willebrand’s factor
Treatment of von Willebrand’s disease, fibrinogen deficiency, and hemophilia A
Apheresis Granulocytes
Neutropenia with infection, unresponsive to antibiotics
Contains RBCs, must be ABO compatible
Often available only for autologous units
Whole blood
Increase oxygen-carrying capacity in anemia, trauma, and surgery
Red Blood Cells (RBCs), Apheresis RBCs
Expiration varies with anticoagulant
Red Blood Cells (RBCs), Apheresis RBCs
Prolonged red cell storage for rare blood units and autologous storage
Frozen/deglycerolized RBCs
24-hour outdate following deglycerolization
Frozen/deglycerolized RBCs
Reduce plasma proteins to avoid allergic and anaphylactic reactions (IgA deficiency)
Washed RBCs
24-hour expiration following washing
Washed RBCs
Avoid febrile nonhemolytic reactions and prevent HLA alloimmunization, reduce
Platelets and RBCs Leukocyte Reduced
CMV transmission
Platelets and RBCs Leukocyte Reduced
Prestorage filtration more effective in avoiding cytokines
Platelets and RBCs Leukocyte Reduced
Prevent GVHD in immunocompromised patients, HLA-matched platelets or transfusions from a blood relative
Irradiated RBCs and Platelets
Irradiation decreases shelf life of RBCs to 28 days
Irradiated RBCs and Platelets
Bleeding caused by thrombocytopenia or thrombocytopathy
Platelets, Pooled Platelets
Pooling reduces expiration to 4 hours
Platelets, Pooled Platelets
Bleeding caused by thrombocytopenia or thrombocytopathy
Apheresis Platelets
May be HLA matched with recipient in cases of refractoriness
Apheresis Platelets
Replace stable and labile coagulation factors
FFP, PF24
Used in surgeries, trauma, and some factor deficiencies
FFP, PF24
Contains fibrinogen, factors XIII and VIII, and von Willebrand’s factor
Cryoprecipitated AHF (CRYO)
Treatment of von Willebrand’s disease, fibrinogen deficiency, and hemophilia A
Cryoprecipitated AHF (CRYO)
Neutropenia with infection, unresponsive to antibiotics
Apheresis Granulocytes
