Blood transfusion Flashcards
when are red cells used?
symptomatic anaemia
haemorrhage
reduced haematocrit
Hb<70
what is in fresh frozen plasma?
all clotting factors, VWF and fibrinogen.
what is fresh frozen plasma used for?
coagulopathy with associated bleeding
need to monitor clotting screen
- DIC with bleeding
- TTP
- INR >6 and bleeding
- bleeding with known coagulation factor deficiency
- liver disease in presence of major bleeding or surgery
- reversal of warfarin when prothrombin complex isn’t available.
what does cryoprecipitate contain?
FACTOR 8
VWF
FIBRINOGEN
what is cryoprecipitate used for?
low fibrinogen levels haemophilia A DIC Liver disease VWF disease after massive transfusion
what are indications for platelet transfusion?
- thrombocytopenia
- platelet function defect
- active bleeding and platelet count <50
- active bleeding with platelet qualitive defect.
- Platelet count <10
- DIC with haemorrhage
what are acute transfusion reactions?
acute haemolytic febrile non haemolytic urticarial anaphylactic TRALI TACO
what are delayed transfusion reactions?
delayed haemolytic
post transfusion purpura
iron overload
what causes an acute haemolytic reaction?
ABO incompatibility is main cause causing an IgM mediated reaction.
what causes febrile non haemolytic reaction?
antibodies in the patients plasma reacting against donors blood
what is the management of febrile non haemolytic reaction?
stop transfuion
give antipyretic and piriton
what is the features of febrile non haemolytic reaction?
fever, rigors 30-60 minutes after the start
what are key differences between TRALI and TACO?
TRALI: due to plasma/platelets
TACO: due to any product
TRALI: onset within 2 hours
TACO: within 6 hours
TRALI: hypotension
TACO: hypertension
TRALI: pulmonary oedema with normal heart size
TACO: pulmonary oedema with cardiomegaly
TRALI: fluid challenege improves
TACO: fluid challenge worsens
what are CI for packed red blood cells?
Refractory anaemia
Coagulation deficiency
what are contraindications for platelet transfusion?
Autoimmune thrombocytopenia
TTP
HIT
what are CI to fresh frozen plasma?
- Can’t be used to reverse heparin
- for use as a volume expander
what are symptoms of an acute haemolytic anaemia?
Rapid onset fever, chills, nausea, pruritus, burning pain at IV site and dyspnoea
Patient appears UNWELL’
what is the management of an acute haemolytic reaction?
Stop the transfusion
Check identity of patient
Send urine and blood- repeat cross match
Give NaCl and start cardiac monitoring
what are symptoms of a febrile non haemolytic reaction?
Fevers and rigors developing after 30-60 minutes of the transfusion.
Patient is hot but not UNWELL.
Can develop fever, rash, chills and malaise
what is the management of a febrile non haemolytic reaction?
stop transfusion
give paracetamol
what blood products can cause TRALI?
Happens with platelets or fresh frozen plasma within 2 hours.
what are signs of TRALI?
hypotension
fever
pulmonary oedema
what is the management of TRALI?
fluid challenge
what is TACO?
fluid overload due to blood products
what are features of TACO?
pulmonary oedema
S3 gallop
venous distension
cardiomegaly
what is the management of TACO?
diuretics and oxygen
