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Anesthesiology > Blood Loss and Transfusion Products > Flashcards

Blood Loss and Transfusion Products Flashcards

1
Q

The use of supportive therapies in patients to correct deficiencies until the underlying cause or disease process can be treated is that goal in what?

A

Transfusion or substitute treatment

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2
Q

What are 6 concerns with transfusions?

A
  • Volume overload
  • Electrolyte disturbances
  • Immunogenicity
  • Availability
  • Cost
  • Transmission of infection
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3
Q

What are 3 things to known going into a case of acute blood loss?

A
  • PCV/TP (taken right before anesthesia)
  • Anticipated losses
  • Patient’s total blood volume
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4
Q

Why is it important to know 20% blood loss?

Why is this number important?

A
  • A loss of > or = 20% leads to a decrease in PCV to > or = 20%
  • Oxygen carrying capacity
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5
Q

What is the minimum PCV value needed in order to carry oxygen?
what should be considered below this level?

A
  • 21%

- Blood transfusion

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6
Q

Cotton tip applicators can hold how much blood?

A

0.2 mL

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7
Q

Gauze can hold about how much blood?

A

5-10 mL

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8
Q

Lab sponges can hold about how much blood?

A

50-100 mL

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9
Q

What is the best method to measure blood loss in gauze?

A

Weigh gauze before and after use.

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10
Q

How much blood can tubing hold?

A

About 120 mL

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11
Q

What are 4 examples of physiological signs that can indicate blood loss?

A
  • Hypotension
  • Tachycardia
  • Baroreceptor reflex
  • Pale mm, prolonged CRT
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12
Q

Blood volume is centralized during shock due to what?

A

Peripheral vasoconstriction

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13
Q

Injectable drugs and inhalants will have a more profound effect on patients in what state?

A

Shock

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14
Q

What does hemorrhage increase?

A

MAC

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15
Q

What does mean arterial pressure (MAP) equal?

A

CO x SVR

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16
Q

To restore circulating volume before signs occur is the goal of what?

A

A blood loss plan

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17
Q

What does cardiac output equal?

A

HR x SV

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18
Q

What are 3 volume replacement options?

A
  • Crystalloid
  • Colloid
  • Blood products
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19
Q

What type of fluid is given with anything less than a 10% loss?

A

Crystalloid

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20
Q

Which has a longer shelf-life, a crystalloid or a colloid?

A

Colloid

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21
Q

What does BES stand for?

A

Balanced electrolyte solution

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22
Q

Crystalloid fluid therapy results in what?

How long does this last?

A
  • Temporary increase in intravascular volume.

- About 15 minutes

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23
Q

What are 2 components missing from crystalloid fluid therapy?

A
  • Proteins

- Oxygen carrying capacity

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24
Q

What are 3 effects of Hypertonic saline?

A
  • Increase CO
  • Increase ABP
  • Decrease SVR
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25
Q

What are 2 fluid volumes increased by hypertonic saline?

What is the ratio?

A
  • Plasma
  • Interstitial fluid
  • 2-4 mL plasma increase/1 mL hypertonic saline
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26
Q

What are 2 things improved by hypertonic saline use?

A
  • Cardiovascular function

- Tissue perfusion

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27
Q

Are the effects of hypertonic saline short or long?

A

Short term

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28
Q

The use of hypertonic saline must be followed by what?

A

BES to avoid ICF deficit

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29
Q

What effect do large molecular weight molecules have on vascular volume?

A

Expands vascular volume

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30
Q

Do colloids have more or less redistribution compared to crystalloids?

A

Less redistribution

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31
Q

How much colloid is given?

A

1 mL colloid/mL lost

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32
Q

Colloid maintain a COP greater than what?

A

17 mmHg

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33
Q

What is the name of a veterinary hemoglobin-based oxygen carrying solution that can be used as a blood substitute?

A

Oxyglobin

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34
Q

What allows oxyglobin to be used in any species?

A

Lack antigenic RBC membrane

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35
Q

What are 2 characteristic of oxyglobin?

A
  • O2 carrying capacity

- Volume expansion

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36
Q

How much oxyglobin is given?

A

10-30 mL/kg total at 10 mL/kg/hr

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37
Q

What are 4 advantages of oxyglobin?

A
  • Multi-species use
  • No testing (type/cross-match)
  • T 1/2 = 18-26 hrs
  • Stored for up to 3 years
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38
Q

What are 5 disadvantages of oxyglobin?

A
  • Volume overload
  • Discoloration
  • Fever
  • Diarrhea
  • Death
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39
Q

What is the body’s largest connective tissue?

40
Q

What are 2 things dosage depends on?

A
  • Patient physical status

- Response to treatment

41
Q

Which type of therapy is favored?

A

Component therapy

42
Q

What are 4 types of blood products commonly used?

A
  • Whole blood
  • Packed red blood cells
  • Fresh frozen plasma
  • Lyophilized albumin
43
Q

With which 2 types of blood products does blood type matter?

A
  • Whole blood

- Packed red blood cells

44
Q

With which type of blood product does blood type only matter in cats?

A

Fresh frozen plasma

45
Q

What are the 2 important blood groups for bovine?

46
Q

What are the 3 important blood groups for canine?

A
  • DEA 1.1
  • DEA 1.2
  • DEA 7
47
Q

What are the 3 important blood groups for equine?

48
Q

What are the 4 important blood groups for feline?

A
  • A
  • B
  • AB
  • Mik
49
Q

What are the 2 important blood groups for ovine?

50
Q

What is the RBC lifespan for bovine in days?

51
Q

What is the RBC lifespan for canine in days?

52
Q

What is the RBC lifespan for equine in days?

53
Q

What is the RBC lifespan for feline in days?

54
Q

What is the RBC lifespan for ovine in days?

55
Q

Is it better to use DEA + or DEA - dog blood for donors?

56
Q

What is the minimum amount of time for antibodies to develop to transfused blood in a canine?

57
Q

What should be done for any transfusions given 5 days or more after the initial transfusion?

A

Type and cross-match

58
Q

What do cats have whether or not they have ever had a transfusion?

A

Naturally occurring preformed alloantibodies

59
Q

T/F: All cats must be typed whether or not they have had a transfusion before.

60
Q

What type of blood can type AB cats receive?

61
Q

99% cats in the US are what blood type?

62
Q

What are 2 indications for the use of whole blood?

A
  • Acute blood loss/hemorrhage

- Anemia

63
Q

What is the shelf-life of whole blood?

A

21-30 days

64
Q

What does refrigeration do to whole blood?

A

Inactivates platelets & WBC

65
Q

Why should a whole blood transfusion be completed within an hour?

A

To prevent bacterial contamination

66
Q

What is the rule of thumb for whole blood transfusion?

A

2 mL/kg of donor blood will raise PCV by 1%

67
Q

The amount of whole blood to be given is equal to what?

A

(desired PCV - actual PCV)/donor PCV x patient blood volume

68
Q

What should always be done with whole blood?

A

Warmed passively using a filter

69
Q

Should a pump be used to administer whole blood?

A

No, pumps will break up RBCs

70
Q

What are 2 indications for packed red blood cells?

A
  • Acute blood loss/hemorrhage

- Anemia

71
Q

What is the shelf-life of packed red blood cells?

72
Q

What are 2 things omitted from packed red blood cells?

A
  • Platelets

- Clotting factors

73
Q

What are 2 examples of anticoagulants?

A
  • Heparin

- 3.8% sodium citrate

74
Q

What is an indication for the use of fresh frozen plasma?

A

Coagulopathies

75
Q

What is the shelf-life of fresh frozen plasma?

A

12 months at -30C

76
Q

Can unused, thawed fresh frozen plasma be re-frozen without loss of function?

A

Yes if re-frozen within 1 hour of being thawed.

77
Q

Plasma has to be frozen when to be made into fresh frozen plasma?

A

Within 8 hours of collection.

78
Q

What are 4 components of fresh frozen plasma?

A
  • Plasma
  • All clotting factors
  • Albumin
  • Immunoglobulins
79
Q

What much fresh frozen plasma has to be given to increase albumin 1 g/dL?

80
Q

What are 2 routes of blood/plasma administration?

81
Q

What is an electrolyte that can’t be given with blood/plasma?
Why?

A
  • Calcium

- Overcomes anticoagulant properties of citrate, will make product clot.

82
Q

What type of fluid can not be given with blood/plasma?

Why?

A
  • Hypotonic fluids

- Will cause hemolysis

83
Q

What is given for a test dose?

A

0.25 mL/kg in the 1st 30 minutes

84
Q

Acute adverse effects of transfusions are seen when?

A

During or within 1st few hours

85
Q

Delayed adverse effects of transfusions are seen when?

A

After transfusion completion

86
Q

What are 4 types of adverse effects of transfusions?

A
  • Acute immunologic
  • Acute non-immunologic
  • Delayed immunologic
  • Delayed non-immunologic
87
Q

What are 3 examples of adverse immunologic effects?

A
  • Hemolysis
  • Febrile
  • Urticaria
88
Q

What are 4 factors found in cryoprecipitate?

A
  • von Willebrand’s factor
  • Fibrinogen
  • Factor XIII
  • Factor VIII
89
Q

The supernatant plasma that is removed from cryoprecipitate after being centrifuged is known as what?

A

Cryo-poor plasma

90
Q

What is an indication for the use of cryo-poor plasma?

A

Treatment of rodenticide intoxication

91
Q

Plasma prepared at lower centrifuge rate than packed red blood cell/plasma preparations is known as what?

A

Platelet-rich plasma

92
Q

Cryopreserved canine platelet concentrations must be transfused slowly in order to prevent what?

A

Bradycardia

93
Q

What can be administered to treat failure of passive transfer?

94
Q

What can be given to increase COP?

95
Q

Does albumin have a long or short half-life?

Anesthesiology (19 decks)

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