Blood Transfusions

Question 1

What gauge cannula are used for blood transfusion?

Answer 1

Green (18G) or grey (16G)

Question 2

Who is eligible to donate blood?

Answer 2

Fit+healthy
Weight between 50-158 kg
Aged between 17-66 yrs or 70 if give blood before in last 2 years.

Question 3

Who cannot Donate blood?

Answer 3

Hep B/C carrier
Have received a blood transfusion before
HIV
Ever been diagnosed with syphillis even if treated
IV Drug users
Used tanning agents, body building, chemosex drugs
HTLV positive

Question 4

What is the definition of a massive blood transfusion?

Answer 4

Replacement of an individuals entire blood volume (>10 units) within 24 hrs

Question 5

What is a major haemorrhage defined as?

Answer 5

The lose of more than 1 blood volume within 24 hours
A lose of 50% total blood volume in under 3 hours
Bleeding in excess of 150ml/min in adults

Clinical:
Systolic BP of <90mmHg
Or HR of >110

Question 6

What are the complications of massive blood transfusion?

Answer 6

Reduced:
Platelets, calcium, clotting factors

Hyperkalemia
Hypothermia

Question 7

What are the major constituents of FFP?

Answer 7

Clotting factors

Question 8

What are the major constitutions of cryoprecipitate?

Answer 8

Fibrinogen, vWF, factor VIII and fibronectin

Question 9

What are the indications and duration of administration for FFP?

Answer 9

DIC
Any haemorrhage secondary to liver disease
All massive haemorrhages (commonly after 2nd pack of RBC)

Duration - 30 mins

Question 10

What are the indications and duration of administration for cryoprecipitate?

Answer 10

DIC with fibrinogen <1g/L
Von Willebrands disease
Massive haemorrhage

Duration - stat

Question 11

What are early complications of blood transfusions?

Answer 11

Acute haemolytic reactions
Anaphylaxis
Bacterial contamination
TRALI (transfusion related acute lung injury)
Non-haemolytic febrile transfusion reaction
Allergic reaction
Fluid overload

Question 12

What are late (>24hrs) complications of blood transfusions?

Answer 12

Infection
Post transfusion purpura
Graft vs. Host disease (GvHD)
Iron overload

Question 13

What can be given to increase Hb concentrations before surgery and how long for?

Answer 13

Iron alone or combined with erythropoiesis stimulating agents

Oral iron takes 2-3 months
IV iron take 2-4 weeks

Question 14

What are the alternatives for blood transfusion?

Answer 14

Tranexamic acid and cell salvage

Iron

Erythropoietin