Blood Transfusion

Question 1

Causes of bleed

Answer 1

Trauma Neoplasia Coagulopathy

Question 2

How to treat haemorrhagic shock

Answer 2

Crystalloids Blood transfusion

Question 3

Criteria for canine blood donor

Answer 3

good temperament Accessible jugular vein no health problems vaccinated, heart worm prophylaxis larger then 25kg for 450ml collection negative for blood borne diseases in the area shouldn’t have previously received a transfusion blood typed

Question 4

Criteria for feline Blood donor

Answer 4

More than 5kg for 50ml collection FeLV/FIV/mycoplasma negative Ideally indoor cat donors of both blood groups required

Question 5

Difference between dog and cat blood antigens

Answer 5

Dogs do NOT have naturally occurring alloantibodies. Cats DO have naturally occurring alloantibodies

Question 6

Canine blood types

Answer 6

Question 7

Rules for giving canine blood

Answer 7

Give Negative blood to a negative or positive recipient

Give positive blood to a positive recipient

Question 8

Feline blood type B cats

Answer 8

Have a very strong anti-A antibodies

-transfusion of A type cells would lead to a very severe haemolytic reaction and a 30% chance of death

Question 9

Blood Type A cats

Answer 9

Have weak anti-B antibodies

• not usually life threatening
• RBCs survive 5-6 days

Question 10

Blood Type AB cat

Answer 10

No alloantibodies to A or B

• should be given AB blood.
• Giving it type A blood will introduce anti-B antibodies which will attack its own RBCs

Question 11

Why use cross matching?

Answer 11

Mix donor and recipient blood to look for agglutination

-Evaluates compatibility

Question 12

Major cross matching

Answer 12

Recipient plasma with the donors RBCs

Protets against lysis of the transfused red cells

Question 13

Minor cross match

Answer 13

Recipients RBCs with donor plasma

protect recipients RBCs

Question 14

Collection of blood

Answer 14

Sterile skin preparation

Closed blood collection system ideal

Question 15

Closed system anticoagulant

Answer 15

CPDA-1

citrate, phosphate, detrose, adenine

allows 21-35 days of storage

Question 16

Anticoagulant in open system

Answer 16

Citrate

Question 17

Steps in administering transfusions

Answer 17

• warm to room temp in water bath(37degrees)

Dont heat above 39degrees as this may destroy anticoagulation factors

-Deliver slowly initially (2-5ml/hr) for 20 mins to allow early recognition of transfusion reactions

NB: as fast as you like in peracute, life-threatening situations

-Give remainder over 4 hours (longer has a bacterial infection risk)

Question 18

Fresh whole blood

Answer 18

RBCs, plasma proteins, all coagulation factors + some functional platelets

Question 19

Stored whole blood

Answer 19

RBCs, plasma proteins, stable coagulation factors

can store for up to 35 days with CPDA-1

Question 20

Autotransfused blood

Answer 20

RBCs, plasma protein and clots

Contraindicated with sepsis and neoplasia

Question 21

Whole blood is indicated in?

Answer 21

Haemorrhagic shock

Coagulopathy coupled with anaemia

Question 22

Packed red blood cells is indicated in?

Answer 22

Anaemia where intravascular volume in normal

• haemolysis
• decreased production
• slow, chronic loss (low GI bleed, fleas)

With other fluids for whole blood loss (hypovolaemia)

Question 23

When to transfuse?

Answer 23

PCV = 20% compromised O2 delivery

More important in an actue injury rather than chronic

Question 24

what is in fresh frozen plasma?

Answer 24

Disorders of secondary haemostasis (rodenticide, SIRS/sepsis, DIC) as it contains all clotting factors, antithrombin and anti-inflammatory proteins

Question 25

Immunologic complications of transfusions

Answer 25

Haemolytic (acute or delayed)

Febrile-non haemolytic

Allergic reaction

TRIM (transfusion immunomodulation)

TRALI (transfusion acute lung injury)

Question 26

Non immunologic complications of transfusions

Answer 26

Non immune mediated haemolysis (mechanical trauma, poor storage)

Bacterial contamination

Citrate toxicity,

Dilutional coagulopathy

Disease transmission

Circulatory overload (TACO)