blood transfusion

Question 1

-no platelets, no factor 5/8/11

useful for massive hemorrhage

Answer 1

whole blood

Question 2

-RBC’s only
hct 60-80% of normal
-less volume expansion
-give you what you need (o2 carrying capacity)

-lacks clotting factors

Answer 2

Packed red blood cells

Question 3

Raise platelet count by 5000 per donor unit

• short half life so rapid transfusion needed
• used to control hemorrhage
  dose: 6-10

Answer 3

platelets

Question 4

• No wbc, rbc, platelets
• clotting factors only
• will restore circulatory procoagulants by 20%, enough to restore clotting
• can reverse coumadin therapy

Answer 4

fresh frozen plasma

Question 5

• inactivates lipid coated viruses
• relatively inert
• consistent coagulation factors
• rapid coumarin reversal
• coagulation factor deficiency
• multiple coagulation defects

Answer 5

Plasma+soluble detergent

Question 6

contains fresh frozen plasma thawed at 4c

-used for factor 9/13 deficiency, von willebrand dz

Answer 6

cryoprecipitate

Question 7

Common complications of all transfusions?

Answer 7

infection; viral>bacterial

• transfusion reactions; acute or delayed hemolytic, non-hemolytic
  
  • occurs immediately or within hrs of transfusion

Question 8

common complications to RBC transfusions

Answer 8

hypocalcemia, hyper/hypo kalemia, acidosis, alkalosis, hypothermia, hemosiderosis, pulmonary dysfunction, hemorrhage

Question 9

most common acute hemolytic transfusion reactions

• unknown etiology
• characterized by puritis

Answer 9

category 1 acute hemolytic transfusion rxn

Question 10

• antibodies to plasma components/wbcs/platelets or related contamination
• characterized by agitation, palpitation, headace, inc HR, dyspnea with exertion

Answer 10

category 2 acute hemolytic transfusion rxn

Question 11

• life threatening
• preformed antibodies in the recipient plasma
• creates intravascular hemolysis
• hemorrhage, cv collapse, hemorrhagic shock

Answer 11

-category 3 acute hemolytic transfusion rxn

Question 12

-occur 1-25 days after transfusion due to primary antibody response

Answer 12

delayed hemolytic transfusion rxn

Question 13

delayed hemolytic transfusion rxn seen in immunocompromised pt and non compromised pt with HLA types

Answer 13

graft vs host dz delayed hemolytic transfusion rxn

Question 14

delayed hemolytic transfusion rxn due to antihemolytic Abs to plasma proteins

risks: pregnancy, multiparity, h/o multiple prior transfusions (sickle cell dz)

Answer 14

alloimmunization delayed hemolytic transfusion rxn

Question 15

delayed hemolytic transfusion rxn with same risk factors as alloimmunization but includes congenital IgA deficiency

Answer 15

anaphylactoid rxn

Question 16

• non-cardiogenic pulmonary edema
• volume overload
• greatest risk in volumically challenged pts
• due to antileukocytic antibodies to donor plasma proteins

Answer 16

non-hemolytic transfusion reactions

Question 17

how do you avoid hemorrhage in massive transfusion?

Answer 17

administer 8-10 units of platelets per 1.5 blood volume given

Question 18

what do you premedicate pts with prior to transfusion?

Answer 18

anti-histamine of choice

antipyretic of choice

these minimize risk of category 1 acute hemolytic rxn