Blood Loss And Transfusion Flashcards
What are the blood products?
Whole blood Packed red blood cells Platelet rich plasma Fresh frozen plasma (cryoprecipitate) Oxyglobin
Whole blood can only be called fresh for how many hours after collection, then it becomes old whole blood
8hourse
What is in whole blood ?
RBC WBC Platelets Plasma proteins Coagulation factors
Old whole blood lacks ??
Some unstable clotting factors
What are indications for whole blood transfusion?
Actively bleeding
Hypovolemia secondary to acute hemorrhage
What is in pRBC?
Packed red blood cells (PCV 70%)
When do you transfuse pRBCs?
Patients with allergic rxns to plasma proteins or with febrile non-hemolytic rxn to WBC
When is platelet rich plasma indicated?
Severe bleeding in thrombocytopenic animals
Pure plasma contains?
Plasma proteins and all clotting factors except platelets
FFP that has been thawed several times is only rich in what clotting factors?
Clotting factor VII
Von willebrand factor
Fibrinogen
What blood product is used to breast anemia in dogs and cats?
Oxyglobin (stabilized bovine hemoglobin based oxygen carrying solution)
What are adverse effects associated with oxyglobin?
Potential for circulatory overload ( colloid effect)
Allergic rxn (repeated dose)
Temporary discolouration of mucus membranes
What are the sources of blood products
From patient itself (auto-transfusion)
Donors (in hospital or from neighboring hospitals)
Animal blood banks
What are indications intra-operatively for blood transfusion
Severe acute hemorrhage
What are the indications for blood transfusion pre-operatively??
Severe acute hemorrhage usually from trauma
Hypoalbuminemia
Thrombocytopenia
Clotting factor deficiency
Transfusion should be started is PCV is ________ causing an acute anemia
<20%
Transfusion should be started is PCV is ________ in a chronic anemia
<15%
How can you estimate blood loss
Amount in surgical site
Soaked swabs
Surface (table/floor spillage)
How much blood do you transfuse in acute hemorrhage?
Administer same amount as lost
Always start slow at 0.25ml/kg for 30 mins then continue at 5-10ml.kg/hr
How do you calculate how much blood to administer in a cat?
blood required (mL) = BW x 70(desired PCV-patient PCV / donor PCV )
How do you calculate how much blood to administer during anemic hemorrhage to a dog?
blood required (mL) = BW x 90(desired PCV-patient PCV / donor PCV )
You should aim to complete a blood transfusion within how much time?
4 hrs
What is the RBC survival time in dog?
110-120 days
RBC survival time in cat?
75-80 days
RBC survival time in horse and cattle
140-155 days
T/F: Blood products and fluid therapies can be administered through the same IV port
False
T/F: cats and dogs required to be blood typed before their first transfusion
False
Dogs - no, lack alloantibodies
Cats- YES
What is the most common blood type in dogs?
DEA 1.1
What blood types in dogs are considered universal donors?
DEA 1.1 and 1.2 negative
What are the blood groups present in cats?
A, B, and AB
Cats have naturally occurring alloantibodies - always type before first transfusion
What are the most common blood groups in horses?
A, C and Q
What are the most antigenic blood types in horses?
Aa and Qa
-pregnant mares carry the most antibodies, use geldings or nulliprous mares for donors
What is major-cross matching?
Recipient plasma to donors RBC
If agglutination, positive cross match, do NOT transfuse
What is minor cross matching?
Donor plasma vs recipient RBC
What are clinical signs of a transfusion reaction?
Tachycardia and dysrhythmia
Hypotension
Tachypnea, dyspnea
Pyrexia
Wheals and urticaria
Vomiting
Seizure/tremors
CV collapse
After a blood transfusion, you see…
Fever, uritcaria, angioedema, puritus, and tachypnea
What type of reaction is this and how would you treat it?
Allergic rxn
Stop transfusion Diphenhydramine \+/- dexamethasone \+/- epinephrine (severe) Restart transfusion at slower rate
After a blood transfusion, you see…
Sudden tachycardia, hypotension, cardiac arrest, and collapse
What type of reaction is this and how would you treat it?
Analylatic shock
Stop transfusion
Symptomatic support (CPR?)
Epinephrine and dexamethasone
After a blood transfusion, you see…
Tachypnea, fever, hemoglobinemia, hemoglobinuria, and shock
What type of reaction is this and how would you treat it?
Acute hemolysis
Stop transfusion
Dexamethasone
Saline diuretics
Maintain BP (dopamine?)
After a blood transfusion, you see…
Slight increase in temp and bradycardia
What type of reaction is this and how would you treat it?
Stop transfusion
Dexamethasone and ketoprofen
Restart at slower rate in 15mins
After a blood transfusion, you see…
Tachypnea, pulmonary edema, and polyuria
What type of reaction is this and how would you treat it?
Circulatory overload
Stop transfusion Oxygen supplementation Furosemide Restart transfusion at a slower rate Consider different blood product
After a blood transfusion, you see…
Low body temp
What type of reaction is this and how would you treat it?
Hypothermia
Stop transfusion and warm blood
After a blood transfusion, you see…
Cardiac arrhythmias, tremors, and seizures
What type of reaction is this and how would you treat it?
Citrate overdoes induced hypocalcemia
Calcium salts and ECG monitoring
After a blood transfusion, you see…
ECG abnormalities
What type of reaction is this and how would you treat it?
Hyperkalemia
Stop transfusion
Normal saline
Dextrose with regular insulin
