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CVNT2 > Blood Transfusions > Flashcards

Blood Transfusions Flashcards

1
Q

what blood products are available to dogs?

A

whole blood
packed RBCs
fresh frozen and frozen plasma
cryoprecipitate and cryoprecipitate poor plasma

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2
Q

what blood products are available for cats?

A

no pet blood banks stock feline blood products - whole blood can be obtained locally

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3
Q

where cat feline blood products be obtained from?

A

cats of consenting clients, friends, family, colleagues
local donor colonies
donors from the animal blood register

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4
Q

when is whole blood considered fresh?

A

<6 hours after collection

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5
Q

what does fresh whole blood contain?

A

physiological concentrations of RBCs

some functional platelets, proteins and coagulation factors

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6
Q

what is stored whole blood?

A

blood used >8 hours after collection

has no functional platelets
lost labile clotting factors

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7
Q

how should stored whole blood be stored?

A

between 2-6°C maximum 21 days

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8
Q

how are packed RBCs separated?

A

by centrifugation

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9
Q

what is the PCV of packed RBCs?

A

70-80%

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10
Q

how should PRBCs be stored?

A

similarly to whole blood

expires ~42 days after extraction

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11
Q

what does fresh frozen plasma contain?

A

all coagulation factors

physiological concentrations of albumin and other plasma proteins

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12
Q

how should FFP be stored?

A

-18°C <1 year

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13
Q

what is frozen plasma?

A

FFP that is >1 year old or that has thawed and been re-frozen

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14
Q

how does frozen plasma differ from FFP?

A

stable coagulation factors will remain but labile factors will be lost e.g. VIII and vWF

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15
Q

how should frozen plasma be stored?

A

-18

5 years

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16
Q

how is cryoprecipitate formed?

A

by slowly and partially thawing FFP which is then centrifuged again - cryoprecipitate is then collected from this second centrifugation

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17
Q

what does cryoprecipitate contain?

A

rich in fibrinogen, VIII and vWF

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18
Q

which common diseases may benefit from transfusion therapy?

A

hypovolaemic anaemia
euvolaemic anaemia (immune-mediated haemolytic anaemia)
coagulopathies

thrombocytopaenia/thrombopathia/
hypoalbuminaemia unlikely to see long term positive effect

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19
Q

when would we consider transfusing an anaemic patient?

A

if there are clinical signs of anaemia - weakness, tachycardia, tachypnoea, high blood lactate

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20
Q

what are the symptoms of a transfusion reaction?

A 
fever 
tachycardia 
dyspnoea 
muscle tremors
vomiting 
weakness 
collapse 
haemoglobinaemia and haemoglobinuria
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21
Q

what antigens can be present in canine blood?

A

dog erythrocyte antigen (DEA) - 1, 3, 4, 5, and 7

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22
Q

which blood antigen is the most antigenic?

A

DEA 1 - typed for in clinical practice

23
Q

do dogs possess antibodies against DEA 1?

A

dogs possess no naturally occurring antibodies against DEA 1

24
Q

how are dalmatians different?

A

they are Dal negative - cannot be typed for in-house

blood must come from another Dalmatian or need to be cross-matched

25
Q

what type of blood should DEA 1 negative dogs receive?

A

only DEA 1 negative

26
Q

what type of blood should DEA 1 positive dogs receive?

A

DEA 1 positive or negative blood

27
Q

what type of blood can be given in an emergency to an untyped recipient?

A

DEA 1 negative

28
Q

why can a dogs first transfusion be untyped?

A

dogs do not possess naturally occurring alloantibodies

29
Q

what is always important to consider with subsequent transfusions in dogs?

A

regardless of blood typing and appropriate transfusion, subsequent transfusions can still lead to reactions due to sensitisation to the remaining DEAs or other RBC antigens

30
Q

what are the 3 blood types of cats?

A

A B AB

31
Q

why must cats always be cross matched for blood type?

A

naturally occurring alloantibodies are present in plasma without prior exposure through transfusion or pregnancy

32
Q

what blood should a type AB cat be given if AB blood is not available?

A

type A blood - has anti-B alloantibodies but they are weak and low in number

33
Q

why is cross matching performed?

A

used to determine the serological compatibility between blood - looks for signs of agglutination

34
Q

what is mixed in a major crossmatch?

A

recipients serum and donors red blood cells

35
Q

what is mixed in minor crossmatch?

A

donors serum and recipients red blood cells

36
Q

cross-matching should be performed when…

A

the recipient has received a transfusion >4 days ago

there has been a history of transfusion reaction

transfusion history is unknown

recipient has been previously pregnant

ideally all feline transfusions

all dalmatians

37
Q

what criteria should donors meet (dogs and cats)?

A

healthy, 1-8 years of age
no history of travel

should be receiving routine preventative healthcare

should never have received a transfusion

should have good jugular veins

38
Q

how large should canine blood donors be?

A

> 25kg

39
Q

how large should feline blood donors be?

A

> 4kg, BCS 4-6/9

40
Q

what additional criteria should feline blood donors meet?

A

must be blood typed

should have ‘clear’ disease screens - FIV, FeLV, mycoplasma haemofelis

ideally only indoor cats

41
Q

what are the volume limits for donation?

A

dogs - 15ml/kg

cats - 10-12ml/kg

42
Q

what should cats be given post-donation?

A

IVFT replacement - isotonic crystalloids at double volume of blood collected

43
Q

what is the disadvantage of open donation?

A

1+ additional sites of potential bacterial contamination

44
Q

what are the advantages/disadvantages of closed donation?

A

a - longer shelf life, less exposed to contaminants

d- only suitable for large dogs

45
Q

how do you administer blood products?

A

visually inspect the bag

frozen products should be gently thawed

administer IV using blood giving sets/normal giving set with filter

record baseline patient parameters and monitor throughout

46
Q

how much blood should be transfused?

A

10-20ml/kg (approx 1% increase in PCV for each 2ml/kg of whole blood given)

47
Q

how rapidly should blood products be given?

A

1ml/kg/hr for 20 mins (allow early recognition of transfusion reactions)
rest over 4-6 hours

48
Q

can patients be fed during transfusion?

A

no - may cause vomiting, may confuse with transfusion reaction

49
Q

can you administer any other drugs through the transfusion catheter?

A

no - only 0.9% saline

could cause haemolysis/blood clots

50
Q

how often should transfusion patients be monitored?

A

prior to transfusion
every 15-30 mins during
1, 12, and 24 hours after transfusion

51
Q

which parameters should be monitored before/during/after transfusion?

A 
mentation 
rectal temperature
pulse rate/quality 
RR and character 
MM colour and CRT 
plasma and urine colour
52
Q

when should PCV/TS be tested?

A

prior to, upon completion and 12-24 hours following transfusion

53
Q

what types of immunologic transfusion reactions are there?

A

antigen-antibody sensitivity reaction

cytokines from product storage/leukocytes within product

allergic/hypersensitivity reaction (IgE mediated)

54
Q

give some examples of non-immunologic transfusion reactions

A 
volume overload 
citrate intoxication 
coagulopathy/thrombosis 
ammonia intoxication 
bacterial contamination of the unit 
pre-transfusion haemolysis

CVNT2 (47 decks)

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