49. Blood management Flashcards
CMV and blood management
FFP and cryo are safe because they are leukoreduced components
CDPA1
Citrate Anticoagulation
Dextrose energy for RBC
Phosphate
Adenosine (increase survival from 21 to 35)
storage from 1 to 6 degrees (inhibits Na/K pump)
Platelets requirements for surgery
> 20 spinal tap
50 surgery
100 neurosurgery
IS phase definition and use
Check against errors in ABO typing. Takes 5 min
For emergency
Safe 99%
Hemorrhagic diathesis after blood
After 20 units 30%
After 25 90%
After 30 100%
Delayed hemorrhagic reaction
2 - 21 days after
By autoantibodies (not detectable in blood)
Window period for infections
HC 3 - 4 d
HIV 5 - 6
Hb 24
HTLV 51
Cryo contents
Factor 8, 13, vW, fibrinogen, fibronectin
TRALI charac
1 - 3%
after 6 h
Non cardiogenic pulmonary edema
Most common source FFP or whole blood
What fluids to give with PC
Dextrose 5% + saline 0.45
Dextrose 5% + 0.9 salline
0.9 saline
Normosol
PF24 vs FFP
PF24 less factor 5 8 compared to FFP
PC
Hct 57%
pH 6.8
HCO3 11
K 20
Na 126
Gluc 24
DIC tests
PT long
Fibrinogen low
BT long
Acute hemorrhage clasification
- < 750 HR 100 RR 14-20 UO 30 Blood loss 15%
- 750 - 1500 100 20-30 20-30 15-30
- 1.5 - 2 120 30-40 20-10 30-40
- > 2 >140 >40 <10 >40
When is not possible to use cell savage
If we use hypotonic fluids on the surgery
Contraindications for autologous blood donation
Adsol
Adenine glucose mannitol NaCl
Extended until 42 days
Htc 50-60%
Survival rate pf RBC after 35 days
70%
Ptl transfusion
At room temperature
Can be without ABO
Risk of infection (syphilis)
Life spam of platelets in whole blood
24 hours
ABO compatibility testing
Where can you see very low and low platelet count?
Very low in TTP
Low in DIC and end stage liver failure
Rate for significant hyperK with blood transfusion
More than 120 ml/min
