Blood Banking Flashcards
What Hgb level is indicative of a PRBC transfusion?
No specific level; Hgb levels can be normal in massive blood loss
Frozen RBC
Frozen in glycerol and can be used for up to 10 years; after thawing, only viable for 24 hrs
Indications: Autologous blood donation, IgA deficiency, Rare blood type
Washed RBC
Indications: IgA deficiency; prevention of allergic rxn to plasma proteins
Platelet Transfusion
6 pack raises platelet count by 30K; stored for 5 days on mixing shelf
Indications: Thrombocytopenia (
Platelet Refractoriness
Patient’s platelets do not increase after 6-pack transfusion
Caused by: splenomegaly, *Anti-HLA antibodies, increased consumption
Leukoreduced Platelets/PRBC
- Decreases incidence of alloimmunization against WBC ags (HLA)
- Decreased risk for CMV transmission
- Decreased risk for non-febrile hemolytic transfusion rxns
FFP
Plasma that is frozen w/in 8 hours of drawing and contains 1 IU of coag factors/mL (200-250 mL= standard volume)
Indications: Significant bleeding w/ factor deficiency; TTP; correction of PT or PTT pre-op; mass transfusion
*and Coumadin toxicity
Cryoprecipitate
Contains high amounts of Factor I, VII, XII, an vWF; stored for a year but once thawed, must be used in 4 hrs
Indication: Fibrinogen replacement
4 Factor PCC
“Prothrombin Complex Concentrate”
- Contains Vitamin-K dependent factors
- Used for rapid reversal of Coumadin therapy
How long is a patient’s crossmatched specimen good for?
72 hours
Acute Hemolytic Transfusion Reaction
Initial symptoms: Fever, chills, SOB, *chest/flank pain, DIC
Pathophysiology: Activates complement, coagulation, and cytokine system; also assoc. w/ jaundice and hemoglobinuria (renal damage)
Lab Investigation: Repeat everything on original and new specimen; Clerical check; DAT; examine serum for evidence of hemolysis; check for hemoglobinuria
Treatment: STOP TRANSFUSION
- Prevent renal failure w/ hydration and maintenance of urine output
- Treat DIC and hypotension
PRBC
Purpose: Increase O2 carrying capacity of the blood (raises Hgb by 1 g/dL)
Indications: Symptomatic anemia
*Can only add normal saline to line and use specific blood warmer
Febrile Non-hemolytic transfusion reactions
Fever or chills w/o presence of hemolysis; caused by exogenous pyrogens
-Can prevent w/ premedication of acetaminophen or use leukoreduced units
TRALI
Transfusion Related Acute Lung Injury
Noncardiogenic acute lung injury =» SOB, fever, pulmonary edema
Path: Donor abs against recipient WBC =»WBCs aggregate in the lungs
Treatment= Supportive
Delayed Hemolytic Transfusion Reaction
Low grade fever days-weeks after transfusion present alongside anemia, jaundice, and hepatosplenomegaly
Path: Patient develops alloantibody against donor RBCs; DAT comes back positive later
Graft Vs. Host Disease
Development of a fever, maculopapular rash, N/V, diarrhea, cholestasis w/ jaundice, and pancytopenia days-weeks after BM transplant
Path: Donor T-cells develop response to host tissue; especially the skin and GI tract
*Prevent by IRRADIATING T-cells
Anaphylaxis
Rapid development of a rash that can progress to death; mediated by IgE (sometimes occurs in IgA deficiency)
Treatment: Epinephrine
*Prevent w/ Washed RBCs
Urticaria
Immediate hypersensitivity following a transfusion mediated by histamines
Treatment: Diphenhydramine
*Prevent w/ treatment of diphenhydramine or washed RBCs
TACO
Transfusion-Associated Circulatory Overload
Hypervolemia =» Increased CVP, pulmonary edema, SOB, hypertension
Treatment: Furosemide
Prevent by slowing transfusion rate
How many mg of iron are in PRBCs?
1mg/mL
Infections from Blood Transfusions
HTLV-1
HIV
HBV, HCV
WNV
CMV (prevent w/ leukoreduction)
HHV
EBV
*Syphilis
Chaga’s Disease
Maximum Blood Ordering Schedule
-Developed a guideline on ordering blood for pre-op
