3 Blood Producs Flashcards
Which blood products have no risk of transmitting HIV and hepatitis?
Albumin
Serum globulins
(They are heat treated)
What diseases are donated blood screened for?
HIV, HepB, HepC, HTLV, syphilis, West nile virus
Who should get CMV-negative blood?
Low-birth-weight infants
Bone marrow transplant patients
Other transplant patients
What is the number one cause of death in blood transfusion reactions?
Clerical error leading to ABO incompatability
What blood type is the universal donor?
Type O blood (contains no antigens)
What blood type is the universal plasma donor?
Type AB blood (contains both antigens)
What is stored blood low in? Effect?
2,3-DPG
Causes an left shift - increased affinity for Oxygen (deceased unloading)
What causes acute hemolytic reaction?
ABO incompatibility - antibody mediated
Symptoms of acute hemolytic reaction?
Back pain, chills, tachycardia, fever, hemoglobinuria
Complications of acute hemolytic reaction?
Acute tubular necrosis
DIC
Shock
Lab findings in acute hemolytic reaction?
Haptoglobin <50mg/dL (binds Hgb, then gets degraded)
Free hemoglobin >5g/dL
Increase in unconjugated bilirubin
Treatment of acute hemolytic reaction?
Fluids Diuretics Bicarb Pressors Histamine blockers
How do transfusion reactions present in an anestheized patient?
Diffuse bleeding
Delayed hemolytic reactions - cause and treatment?
Antibody-mediated against minor antigens
Observe is stable
Nonimmune hemolytic reactions - cause and treatment?
From squeezed blood
Treat with fluid and diuretics
What is the most common transfusion reaction?
Febrile, non-hemolytic transfusion reaction
Febrile, non-hemolytic reactions - cause and treatment?
Recipient antibody reaction against donor WBCs.
Treat by discontinuing the transfusion.
Future transfusions should go through WBC filters.
Anaphylaxis transfusion reactions - cause and treatment?
Recipient antibodies against donor IgA in IgA-deficient recipient
Presents as bronchospasm, hypotension, urticaria
Treat: fluids, Lasix, pressors, steroids, epinephrine, histamine blockers
Urticaria transfusion reactions - cause and treatment?
Recipient antibodies against donor plasma proteins
Treat: Histamine blockers, supportive
What is the cause of TRALI?
Transfusion-related acute lung injury
Caused by DONOR antibodies to RECIPIENT WBCs
Clots occur in pulmonary capillaries
When do you see dilutional thrombocytopenia?
After 10 uPRBCs
Effect of cold on clotting?
Failure - patients need to be warm to clot correctly
Effect of calcium on clotting?
Required for clotting cascade
Hypocalcemia occurs with massive transfusions
What is the most common contaminate of blood products?
GNRs (usually E. coli)
What is the most common blood product to contain contaminants?
Platelets (they are not refrigerated)
