Blood Transfusion in Practice

Question 1

What blood products can be prescribed and for what is each given?

Answer 1

Red cells- anaemia
Platelets- thrombocytopenia
Fresh frozen plasma- low coagulation factors
Cryoprecipitate- Low fibrinogen

Question 2

When is a transfusion given to aid anaemia?

Answer 2

When Hb is <70 or <100 with cardiac impairment

Question 3

What are the indications for FFP?

Answer 3

Replacement of coagulation factors due to major haemorrhage
DIC in the presence of bleeding
Thrombotic Thrombocytopenic Purpura (TTP)
Replacement of coagulation factor deficiencies where factor concentrate unavailable

Question 4

What are the indications for cryoprecipitate?

Answer 4

Hypofibrinogenaemia secondary to massive transfusion; >1.5g/L
DIC with bleeding and fibrinogen <1g/L
Bleeding associated with thrombolytic therapy causing hypofibrinogenaemia
Renal or liver failure and abnormal bleeding
Inherited hypofibrinogenaemia if fibrinogen concentrate unavailable

Question 5

What are the possible causes and treatment of a pyrexic acute transfusion reaction?

Answer 5

Causes- FNHTR

Treatment- anti-pyrexics, other symptoms usually bigger concern

Question 6

What are the possible causes and treatment of an urticaria acute transfusion reaction?

Answer 6

Causes- mild allergic reaction, anaphylaxis

Treatment- antihistamine, other symptoms usually bigger concern

Question 7

What are the possible causes and treatment of a dyspnoea acute transfusion reaction?

Answer 7

Causes- TACO, TRALI, anaphylaxis

Treatment- oxygen, diuretic, ventilation, adrenaline

Question 8

What are the possible causes and treatment of a shock acute transfusion reaction?

Answer 8

Causes- IBCT, anaphylaxis, TRALI, TAS

Treatment- adrenaline, IV fluid, ventilation, antibiotics, FFP/platelets if DIC