Blood Products Flashcards
All blood products carry the risk of HIV and hepatitis except which 2? Why?
Albumin and serum globulins do not carry this risk because they are heat treated
All donated blood is screened for what diseases?
HIV, HepB, HepC, HTLV, syphilis, and West Nile Virus
In what patients is CMV-negative blood used?
Low-birth weight infants, bone marrow transplant patients, and other transplant patients
What type of blood is the universal donor and why?
Type O blood because it contains no antigens
Who should receive Rh-negative blood?
Females of child bearing age
What causes stored blood to have an increased affinity for oxygen?
Stored blood is low in 2,3-DPG which causes a left shift and increased affinity for O2
What is the purpose of type and cross match?
To determine ABO compatibility
What is the purpose of a type and screen?
Determines ABO compatibility and looks for preformed AB’s to minor antigens
How much should one unit of pRBCs raise the Hgb? Hct?
Hgb should raise by 1 and Hct should raise between 3-5
How much should one 6-pack of platelets raise the platelet count by?
50,000
What causes acute hemolysis reaction?
ABO incompatibility
What mediates acute hemolysis reaction?
Antibody mediated. Type II hypersensitivity
What are signs of acute hemolysis reaction?
Back pain, chills, tachycardia, fever, hemoglobinuria
What are some complications of acute hemolysis reaction?
ATN, DIC, shock
What lab values are abnormal in acute hemolysis reaction?
Haptoglobin <50
Free Hgb >5
Increase in unconjugated bilirubin
What is the treatment for acute hemolysis reaction?
Fluids, diuretics, HCO3-, pressors
How may transfusion reactions present in anesthetize patients?
Diffuse bleeding
What causes delayed hemolysis reaction?
Antibody-mediated against minor antigens from donor
What sign is present in delayed hemolysis reaction?
Mild jaundice
What is the treatment for delayed hemolysis reaction?
Observe if stable
What causes non-immune hemolysis?
Squeezed blood
What is the treatment for non-immune hemolysis?
Fluids and diuretics
What is the most common transfusion reaction?
Febrile non-hemolytic transfusion reaction
What is the usual cause of febrile non-hemolytic transfusion reaction?
Recipient antibody reaction against donor WBCs (cytokines release)
What is the treatment for febrile non-hemolytic transfusion reaction?
Discontinue transfusion if patient had previous transfusions or if it occurs soon after transfusion has begun
If patient has history of febrile non-hemolytic transfusion reaction, what should be done if they need a transfusion in the future?
Use WBC filters for subsequent transfusions
What causes urticaria after transfusion?
Recipient antibodies against donor plasmas proteins or IgA in IgA-deficient patient
Usually not hemolytic
What is the treatment for urticaria after transfusion?
Histamine blockers (Benadryl), supportive
What are the signs of anaphylaxis?
Hypotension, broncospasm, angioedema, urticaria
What usually causes anaphylaxis after transfusion?
Recipient antibodies against donor IgA in IgA-deficient patient
What is the treatment of anaphylaxis after transfusion?
Epinephrine, fluids, pressors, steroids, histamine blockers (Benadryl)
What causes transfusion-related acute lung injury after transfusion?
Caused by donor antibodies to recipient’s WBCs, which causes clot in pulmonary capillaries
RARE
What is the complication of transfusion-related acute lung injury?
Noncardiogenic pulmonary edema in <6 hours (ARDS)
What is the most common cause of death from transfusion reaction?
Transfusion-related acute lung injury
What can occur with massive transfusion?
Dilutional thrombocytopenia and dilution of coagulation factors
What electrolyte imbalance can occur with transfusions? What can it lead to?
Hypocalcemia
Can cause poor clotting because Ca is needed for the clotting cascade
What vital sign may be altered in a patient with hypocalcemia?
Hypotension
Why is infusing cold products or transfusing in a cold patient bad?
It can cause poor clotting due to slowing of enzyme reactions
Must warm patient to restore clotting
What often causes hypocalcemia after transfusion?
Citrate used in stored blood binds Ca
What is the most common bacterial contaminant in stored blood products?
Gram negative rods (E coli)
What is the most common blood product source of contamination and why?
Platelets- because they are not refrigerated
What exotic disease can be transmitted through transfusions?
Chagas’ disease
