Blood Components Flashcards
when are antigens formed on RBCs and platelets?
early in fetal life
what condition are ABO mismatches associated with?
acute hemolytic transfusion reactions
when are antibodies in the system formed? how are they stimulated?
after birth
non-immune stimulated
what is the most important blood group?
ABO
what is the second most important blood group?
Rh type
reflects the presence or absence of a single D antigen and is present only on RBCs
Rh
exposure to as little as 1 ml of Rh type cells can stimulate what?
antibody production
what are 4 things all donor blood must be tested for?
ABO group
Rh type
unexpected antibodies
infectious disease
test that detects immune coating of RBCs, used in transfusion reaction workup, autoimmune hemolytic anemia workup, and HDFN
direct antiglobulin test (DAT)
what should be assessed in pregnant women?
risk of HDFN (hemolytic disease of the fetus and newborn)
type and screen + units crossed/held for a specific patient in case they need it
type & cross
what is the transfusion threshold/hemoglobin in a adult that is hemodynamically stable?
7 gm/dl
what is the transfusion threshold/hemoglobin in a adult that is undergoing orthopedic, cardiac surgery, or with pre-existing CV disease?
8 gm/dl
whole blood that is spinned down, removing most of the plasma in the unit
packed RBCs
what do PRBCs not have? (3)
platelets
WBCs
coagulation factors
maximizes O2 delivery without increasing volume, used for acute blood loss, trauma, surgery, intrauterine and exchange transfusion
PRBCs
which condition can be treated with PRBCs if it is not responding to other treatment?
symptomatic anemia
RBCs are only given with what?
normal saline
what must be compatible when using PRBCs?
ABO and Rh match
in using PRBCs, in which patients is Rh match especially important? (2)
children
women of child-bearing years
in an average sized individual, how does 1 unit of PRBCs increase HCT and Hgb?
increases HCT by 3%
increases Hgb by 1 gm/dl
decreases risk of sensitization to human leukocyte antigen, febrile non-hemolytic transfusion reactions, and cytomegalovirus transmission
leukoreduced units
removes most of plasma in PRBCs
washed PRBCs
when do washed PRBCs become outdated?
24 hours once washed
neonates, intrauterine transfusions, IgA deficient patients, and patients with repeated allergic reactions should use which transfusion product?
washed PRBCs
what are the uses of frozen RBCs? (2)
store rare blood types
military stockpile
how long can frozen RBCs be stored? when do they become outdated?
stored up to 10 yrs
outdate 24 hours-14 days after being thawed
decreases risk of transfusion-associated graft-vs-host disease, used for immunocompromised patients
irradiated units
exchange transfusion in neonates, often used in severe HDFN
pediatric aliquots
contains all labile and stable coagulation factors, protein C and protein S - great for patients who need coagulation
fresh frozen plasma (FFP)
in fresh frozen plasma, it must be _____ compatible, but _____ is not considered since it is only present on RBCs
ABO
Rh
what is the shelf life of fresh frozen plasma once thawed?
24 hours
frozen fresh plasma can reduce the effects of what medication?
warfarin
made from FFP, contains fibrinogen, factor VIII, VW factor, and factor XIII
CRYO (cryoprecipitated anti-hemophilic factor)
what is the shelf life of CRYO?
4 hours
CRYO does not have to be _____ or ___ matched
ABO
Rh
what is the primary use for CRYO?
hypofibrinogenemia (fibrinogen less than 100)
treats bleeding
how long does CRYO work in a patient?
12 hours
do platelets need to be ABO and Rh compatible?
yes
what is the shelf life of platelets? how is it stored?
5 days
room temp
all units of platelets are tested for what?
this decreases the risk of what?
bacterial contamination
decreases the risk of septic shock
in which 2 cases are platelets NOT used?
immune thrombocytopenic purpura
thrombotic thrombocytopenic purpura
what occurs in a patient if they do not get the expected platelet increase? SAF-D
sepsis
active bleeding
fever
DIC
antibody-mediated destruction that occurs when a patient becomes immune to the use of products
refractory
what is required in a refractory situation?
HLA-matched platelets for future transfusions
removes specific components and returns the remainder to the donor
apheresis
how long does apheresis collection take?
1.5-3 hours
when is apheresis used?
when we want to pick a specific product from the donor
what are 3 situations when we would want cell depletions via apheresis?
leukemia with high WBCs
polycythemia vera
sickle cell complications
what are 2 situations when we would want therapeutic plasma exchange?
remove autoantibodies
remove alloantibodies
when is leukapheresis done? (2)
septic + not responding to antimicrobials
WBCs > 500,000
used in place of manual bone marrow collections to obtain cells for transplant
peripheral blood stem cells
what are peripheral blood stem cells used to treat? (2)
leukemia or lymphoma
inherited immune deficiencies
what kind of blood products should patients receive, if they are getting peripheral blood stem cells?
irradiated blood
colloid volume expander that draws extravascular fluid into intravascular flow
serum albumin
is ABO and Rh match required for serum albumin?
no
what product should be used in a shock, burn patient, early in massive transfusion, or replacement of fluid in therapeutic plasma exchanges?
serum albumin
pooled human plasma that provides antibodies in congenital immunodeficiency, immune cytopenia, post-transplant, and graft vs host disease
intravenous immunoglobulin
in which patients is intravenous immunoglobulin NOT indicated?
DIC patients
given to pregnant Rh negative women with Rh positive fetus
Rh immune globulin
what does Rh immune globulin prevent?
sensitization from fetal Rh positive cells
at what point in time is Rh immune globulin given?
at week 28
postnatal within 72 hours
in which 2 patients are Rh immune globulins given?
Rh negative women
children who are given Rh positive blood
used for hemophilia A
factor VIII
used in severe bleeding and counteracts warfarin effects
recombinant factor VII
contains factor II, VII, IX, and X;
is vitamin K dependent
factor IX concentrate (prothrombin complex)
