Blood Products Flashcards
RED BLOOD CELL PRODUCTS
-Ordered as packed cells or PRBC
-Processed by one of two different filtration systems which are:
1.
2.
-Anticoagulant is ________ _________ __________ and additive is SAGM (______, ________, _________ and _________)
-Whole Blood Filtration
- Buffy Coat Production
Citrate Phospate Dextrose (CPD)
Saline, Adenine, Glucose, Mannitol
____mL of WB collected in ___mL of CPD
* Collected in DEHP plasticized bags
* Each unit raises Hgb by __g/L
480; 70
10
______ system- Move contents of whole blood between bags without exposure to air.
-its Shelf life is valid for ___days if stored at 1-6C in the original closed system bag (SAGM used).
Avg vol is ____+/- 26 mL
Closed
42
293
Entering the bag after component separation at the hospital
The port is ‘_______’
-purpose: To modify contents or to remove an aliquot for a small volume transfusion
breached
What happens to the shelf life if you ‘enter’ or ‘breach’ the bag?
- Increased risk of bacterial contamination
- Adjusted Expiry Date
- Must be used within ____ hours stored at 1-6 ˚C
- Transfusing a unit of blood through infuser must be done within __ hours
24
4
Testing of Red Cell Products
Prior to making blood components available for transfusion the donor blood is tested for:
1) Antibodies to HIV-1 and HIV-2, HCV, HTLV and HBcore
2) HBsAg
3) Viral RNA HIV-1 and HIV-2
4) DNA HBV
5) Syphilis (Treponema pallidum)
6) WNV and Chagas are performed on at risk donors
7) CMV results will be indicated on label if tested
Storage and Handling
-RBCs are stored in the fridge at a temp between 1C to 6C
-The shelf life or ‘expiry date’ is based on the _________ and the ________ solution
-CBS processes WB and RBC in a ‘closed’ sterile system so that blood is not exposed to air and potential bacterial contamination
The shelf life is __ days unless otherwise specified
-Modifications will change the storage method and the expiry date
-Modifications at the hospital will also change the expiry date example is a Neonatal Unit
anticoagulant
additive
42
After a packed cell is issued and NOT used, it can be returned within ___ mins, after __ mins it is discarded.
IF issued in a cooler, unit can be returned within the __-hour time frame.
60; 60
3
Indications and Contraindications
-RBC LR SAGM PC is not suitable for clinical situations where limited oxygen carrying capacity is not due to RBC deficiency or dysfunction.
___________- also known as volume depletion or volume contraction and loss of salt and water.
Hypovolemia
Indications and Contraindications
Hypovolemia without significant red cell mass deficit is best managed with _________ solutions such as albumin or 10% Pentastarch or crystalloid solutions.
colloid
Indications and Contraindications
-Transfused red blood cells increase the oxygen carrying capacity of the blood by increasing the circulating RBC mass
-Alternatives to transfusion should be considered prior to the transfusion of RBC
-Anemias should be treated with appropriate specific non-blood derived therapy such as iron, Vitamin B12, folic acid and recombinant erythropoietin.
Indications and Contraindications
-Acute blood loss (maintain >__ g/L during active bleeding)
-Chronic anemia
-Cardiopulmonary compromise (maintain >__ g/L)
-Disease and medication effects associated with bone marrow suppression
-Pre-operative patients
-Pediatrics
-Decision to transfuse should not be based on a single Hgb value, must consider all critical physiologic and surgical factors affecting oxygenation and clinical status of the patient.
> 70
> 80
Indications and Contraindications
-Choosing Wisely suggests to NOT transfuse if patient is asymptomatic, nonbleeding, in patients with a Hgb of ___ g/L.
-Examine the possibilities for reversal of anemias by non transfusion treatment
70
Warnings and Precautions
-Red Blood cells must be ___ compatible
-Pre-transfusion testing is required unless withholding blood might result in loss of life
* Rh negative recipients should receive __ ________ red cells
* DEHP plasticizer gradually leaches into the RBC during storage (populations who may be at most risk include fetuses, newborns who require massive transfusions)
* Currently no scientific proof suggesting it is toxic risk for patients
* Minimize exposure by using freshest possible unit
ABO
Rh Negative
Warnings and Precautions
-Less than __-__ days old should be considered when large volumes are transfused to neonates
-Fetus requiring IUT use _______ and ____ negative product
- Alloimmunization of recipient may be of a consequence
- Patients transfused with large volumes of RBC should be monitored for circulatory overload (TACO)
- Transmission of infectious diseases
-Adverse events related to blood transfusion range in severity from minor to life threatening
-Evaluated to determine if transfusion should continue or be restarted
* Report to transfusion BBK department and Canadian blood Services
7-14
irradiated and CMV negative
Dose and Administration
Dose: Each Unit should raise the hemoglobin concentration in an average size nonbleeding adult by approximately __ g/L
Common pediatric dosing is __-__ mL per kg body weight
Recommendations for keeping HGB / HCT at a certain level based on patient condition
-A standard blood administration set containing a ___- ___ micron filter approved by Health Canada
* A blood warmer maybe used at discretion of physician
-Co-administration of 0.9 % sodium chloride injection, ABO compatible plasma or 5% albumin can be performed at the discretion of the physician.
All transfusions should be complete within __ hours
-During transfusion patients are closely observed during the first __ mins and in intervals
10
10-15 mL
170-260
4 hours
15 minutes
Modifications to RBC products
- __________ _________ ___________
-Frozen in glycerol and can be stored for 10 years
-Used for transfusion of patients who may need rare or specific phenotypes
-Especially patients who require regular transfusions & have multiple antibodies
DEGLYCEROLIZED RED CELL
Modifications to RBC products
- ____________
-Gamma Rays destroy the lymphocytes ability to divide
-Cells are exposed to gamma irradiation
*** Recipients are immunocompromised **:
1) Newborns
2) Congenital T cell Immunodeficiency
3) Acquired deficiency
4) Cell transplant / BM
- Chemo patients who have CLL, Lymphoma, BM transplant and certain drugs.
-Used in recipients who are not capable to eliminate these cells
-Reduces the risk of GVHD
Expires __ days post irradiation or __ days post collection
GVHD has a mortality rate of __% and leads to bone marrow failure; happens __-__ days post transfusion
Irradiated
14 days
28 days
90%
8-10 days
Modifications to RBC products
- _________ ______
–Original red blood cell unit is collected or stored into a special Quad pack
-A blood bag with smaller volume satellite packs attached
* One unit can be used for several smaller transfusions without ‘entering’ a port
* Used for neonatal transfusions
* Can be done at CBS
* sterile system: no change in expiry date
* Not the same as manually entering packs
* if a regular unit is ‘entered’ at the hospital it must be used in ___ hours
Divided packs
24
Modifications to RBC products
- _____ __________
-used for intrauterine transfusion as per indication by National Advisory Committee for blood and blood products in Canada
-Difficulty in detecting and monitoring fetal infection, lack of effective utero therapy
CMV Negative
-it is a type of infection Contracted through BF, Blood transfusion and transplants (Organs and tissues).
–Healthy individuals are asymptomatic, mild nonspecific illness similar to mono.
-Immunocompromised can develop CMV disease and pneumonia, hepatitis and Colitis.
-Immune response is to develop CMV IgG antibody (6-8 weeks)
-Virus is dormant (latent) in monocytes of WBC and can react later, never cleared from the system
CMV (Cytomegalovirus human herpes virus- 5 DNA)
Modifications to RBC products
- _______ ________
-USED IF THERE IS AN INCREASE RISK OF ANAPHYLACTIC REACTION WITH STANDARD RBC PRODUCTS
-IgA deficient individuals can produce Anti-IgA
–Decreases the level of residual substances (antibodies, serum proteins such as IgA, additive solutions, potassium, cellular metabolites and cytokines).
-RBCs are washed with 1-2 L of normal saline and total volume remaining is 180 mL
________ ________ - -Must be done within first 2 weeks of storage, used within 7 days of expiry
____ deficient- Labelled with RBC LR washed or RBC LR extra washed
_______ _______- must be used within 24 hours due to increase of possible bacterial contamination
Washed Cells
Automated wash
IgA
Manual Wash
Identify the Modified component:
Description:
-most of the plasma is removed; unit contains >=75% red blood cells from original unit after washing. ______ RBCs are suspended in 100 mL SAGM
INDICATION:
-recipient with a history of severe or repeated reactions to blood components (unresponsive to pre-medication)
Storage:
1-6C: transfuse within 7 days
20-24C: transfuse within 4 hours
Washed Cells
washed
Identify the Modified component:
DESCRIPTION:
most of the plasma removed; unit contains >=75% of RBCs from original unit after washing. ____ RBCs are resuspended in 100 mL SAGM
INDICATION:
-igA-deficient recipient with anti-IgA
STORAGE:
1-6C: transfuse within 7 days
20-24C: transfuse within 4 hrs
Extra Washed (IPA deficient)
