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
2
Q
What are 6 concerns with transfusions?
A
- Volume overload
- Electrolyte disturbances
- Immunogenicity
- Availability
- Cost
- Transmission of infection
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
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
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
6
Q
Cotton tip applicators can hold how much blood?
A
0.2 mL
7
Q
Gauze can hold about how much blood?
A
5-10 mL
8
Q
Lab sponges can hold about how much blood?
A
50-100 mL
9
Q
What is the best method to measure blood loss in gauze?
A
Weigh gauze before and after use.
10
Q
How much blood can tubing hold?
A
About 120 mL
11
Q
What are 4 examples of physiological signs that can indicate blood loss?
A
- Hypotension
- Tachycardia
- Baroreceptor reflex
- Pale mm, prolonged CRT
12
Q
Blood volume is centralized during shock due to what?
A
Peripheral vasoconstriction
13
Q
Injectable drugs and inhalants will have a more profound effect on patients in what state?
A
Shock
14
Q
What does hemorrhage increase?
A
MAC
15
Q
What does mean arterial pressure (MAP) equal?
A
CO x SVR
16
Q
To restore circulating volume before signs occur is the goal of what?
A
A blood loss plan
17
Q
What does cardiac output equal?
A
HR x SV
18
Q
What are 3 volume replacement options?
A
- Crystalloid
- Colloid
- Blood products
19
Q
What type of fluid is given with anything less than a 10% loss?
A
Crystalloid
20
Q
Which has a longer shelf-life, a crystalloid or a colloid?
A
Colloid
21
Q
What does BES stand for?
A
Balanced electrolyte solution
22
Q
Crystalloid fluid therapy results in what?
How long does this last?
A
- Temporary increase in intravascular volume.
- About 15 minutes
23
Q
What are 2 components missing from crystalloid fluid therapy?
A
- Proteins
- Oxygen carrying capacity
24
Q
What are 3 effects of Hypertonic saline?
A
- Increase CO
- Increase ABP
- Decrease SVR
25
What are 2 fluid volumes increased by hypertonic saline?
| What is the ratio?
- Plasma
- Interstitial fluid
- 2-4 mL plasma increase/1 mL hypertonic saline
26
What are 2 things improved by hypertonic saline use?
- Cardiovascular function
| - Tissue perfusion
27
Are the effects of hypertonic saline short or long?
Short term
28
The use of hypertonic saline must be followed by what?
BES to avoid ICF deficit
29
What effect do large molecular weight molecules have on vascular volume?
Expands vascular volume
30
Do colloids have more or less redistribution compared to crystalloids?
Less redistribution
31
How much colloid is given?
1 mL colloid/mL lost
32
Colloid maintain a COP greater than what?
17 mmHg
33
What is the name of a veterinary hemoglobin-based oxygen carrying solution that can be used as a blood substitute?
Oxyglobin
34
What allows oxyglobin to be used in any species?
Lack antigenic RBC membrane
35
What are 2 characteristic of oxyglobin?
- O2 carrying capacity
| - Volume expansion
36
How much oxyglobin is given?
10-30 mL/kg total at 10 mL/kg/hr
37
What are 4 advantages of oxyglobin?
- Multi-species use
- No testing (type/cross-match)
- T 1/2 = 18-26 hrs
- Stored for up to 3 years
38
What are 5 disadvantages of oxyglobin?
- Volume overload
- Discoloration
- Fever
- Diarrhea
- Death
39
What is the body's largest connective tissue?
Blood
40
What are 2 things dosage depends on?
- Patient physical status
| - Response to treatment
41
Which type of therapy is favored?
Component therapy
42
What are 4 types of blood products commonly used?
- Whole blood
- Packed red blood cells
- Fresh frozen plasma
- Lyophilized albumin
43
With which 2 types of blood products does blood type matter?
- Whole blood
| - Packed red blood cells
44
With which type of blood product does blood type only matter in cats?
Fresh frozen plasma
45
What are the 2 important blood groups for bovine?
- B
| - J
46
What are the 3 important blood groups for canine?
- DEA 1.1
- DEA 1.2
- DEA 7
47
What are the 3 important blood groups for equine?
- A
- C
- Q
48
What are the 4 important blood groups for feline?
- A
- B
- AB
- Mik
49
What are the 2 important blood groups for ovine?
- B
| - R
50
What is the RBC lifespan for bovine in days?
140-160
51
What is the RBC lifespan for canine in days?
110-120
52
What is the RBC lifespan for equine in days?
140-150
53
What is the RBC lifespan for feline in days?
75-80
54
What is the RBC lifespan for ovine in days?
64-94
55
Is it better to use DEA + or DEA - dog blood for donors?
DEA -
56
What is the minimum amount of time for antibodies to develop to transfused blood in a canine?
5 days
57
What should be done for any transfusions given 5 days or more after the initial transfusion?
Type and cross-match
58
What do cats have whether or not they have ever had a transfusion?
Naturally occurring preformed alloantibodies
59
T/F: All cats must be typed whether or not they have had a transfusion before.
True
60
What type of blood can type AB cats receive?
Type A
61
99% cats in the US are what blood type?
Type A
62
What are 2 indications for the use of whole blood?
- Acute blood loss/hemorrhage
| - Anemia
63
What is the shelf-life of whole blood?
21-30 days
64
What does refrigeration do to whole blood?
Inactivates platelets & WBC
65
Why should a whole blood transfusion be completed within an hour?
To prevent bacterial contamination
66
What is the rule of thumb for whole blood transfusion?
2 mL/kg of donor blood will raise PCV by 1%
67
The amount of whole blood to be given is equal to what?
(desired PCV - actual PCV)/donor PCV x patient blood volume
68
What should always be done with whole blood?
Warmed passively using a filter
69
Should a pump be used to administer whole blood?
No, pumps will break up RBCs
70
What are 2 indications for packed red blood cells?
- Acute blood loss/hemorrhage
| - Anemia
71
What is the shelf-life of packed red blood cells?
35 days
72
What are 2 things omitted from packed red blood cells?
- Platelets
| - Clotting factors
73
What are 2 examples of anticoagulants?
- Heparin
| - 3.8% sodium citrate
74
What is an indication for the use of fresh frozen plasma?
Coagulopathies
75
What is the shelf-life of fresh frozen plasma?
12 months at -30C
76
Can unused, thawed fresh frozen plasma be re-frozen without loss of function?
Yes if re-frozen within 1 hour of being thawed.
77
Plasma has to be frozen when to be made into fresh frozen plasma?
Within 8 hours of collection.
78
What are 4 components of fresh frozen plasma?
- Plasma
- All clotting factors
- Albumin
- Immunoglobulins
79
What much fresh frozen plasma has to be given to increase albumin 1 g/dL?
45 mL/kg
80
What are 2 routes of blood/plasma administration?
- IV
| - IO
81
What is an electrolyte that can't be given with blood/plasma?
Why?
- Calcium
| - Overcomes anticoagulant properties of citrate, will make product clot.
82
What type of fluid can not be given with blood/plasma?
| Why?
- Hypotonic fluids
| - Will cause hemolysis
83
What is given for a test dose?
0.25 mL/kg in the 1st 30 minutes
84
Acute adverse effects of transfusions are seen when?
During or within 1st few hours
85
Delayed adverse effects of transfusions are seen when?
After transfusion completion
86
What are 4 types of adverse effects of transfusions?
- Acute immunologic
- Acute non-immunologic
- Delayed immunologic
- Delayed non-immunologic
87
What are 3 examples of adverse immunologic effects?
- Hemolysis
- Febrile
- Urticaria
88
What are 4 factors found in cryoprecipitate?
- von Willebrand's factor
- Fibrinogen
- Factor XIII
- Factor VIII
89
The supernatant plasma that is removed from cryoprecipitate after being centrifuged is known as what?
Cryo-poor plasma
90
What is an indication for the use of cryo-poor plasma?
Treatment of rodenticide intoxication
91
Plasma prepared at lower centrifuge rate than packed red blood cell/plasma preparations is known as what?
Platelet-rich plasma
92
Cryopreserved canine platelet concentrations must be transfused slowly in order to prevent what?
Bradycardia
93
What can be administered to treat failure of passive transfer?
Serum
94
What can be given to increase COP?
Albumin
95
Does albumin have a long or short half-life?
Long
