blood transfusions Flashcards by Rose Richmond

when are packed RBCs used

transfusion chronic anaemia // major bleed

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what is the universal donor for FFP

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what platelet rich plasma used for

thrombocytopaenic patients who are bleeding/ need surgery

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what is in FFP

clotting factor, albumin, Ig

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when is FFP used

clinically significant (but not major) bleeding if prolonged PT or APTT // prophylaxis of significant bleed

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what is cryoprecipate

formed from FFP // heavy on VIII + fibrinogen (also vwf)

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when is cryoprecipate indicated

massive haemorrhage + bleeding in haemophilia // fibrinogen <1.5 if clinically significant bleed

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examples of conditions cryoprecipitate may be indicated

DIC, liver failure, secondary to massove transfusion

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what is SAG-mannitol blood

blood with no plasma but has: NaCl, adenine, glucose, mannotol

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what components of blood transfusion do not need to be ABO cross matched

platelets

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what are cell saver devices

save patients blood during surgery and reinfuse it (good for jehovahs witnesses)

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blood products in warfarin reversal

stop warfarin // 2. VitK // 3. FFP // 4. human prothrombin complex

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what is the transfusion threshold for patients w/o ACS to receive RBCs

70 g/L

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what is the transfusion threshold for patients with ACS to receive RBCs

80 g/L

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in a non-urgent scenario, how quickly is a unit of RBC transfused

90-120 mins

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in active bleeding, what platelet count indicates transfusion if clinically significant

<30 eg haematemesis, malaena, epistaxis

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in severe active bleeding, what platelet count indicates transfusion

<100 if significant bleed or bleeding to CNS

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threshhold for platelet transfusion with no bleeding/ planned invasive procedure

<10

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when is platelet transfusion contraindicated

chronic bone marrow failure // autoimmune thrombocytopenia // heparin thrombocytopenia // TTP

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when are granulocyte colony stimulating factors transfused

neutropenic patients (usually secondary to chemo) // filgrastim, perfilgrastim

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what type of blood is CMV transmitted in

leukocoytes

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what is irradiated blood

depleted T cells

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what is irradiated blood used for

avoid graft vs host disease

what type of blood do intra-uterine transfusions requre (CMV, irradiated)

both

what type of blood do neonates require (CMV, irradiated)

CMV + irradiated

what type of blood transfusions in pregnancy require (not labour or delivery) (CMV, irradiated)

CMV negative

what type of blood do bone marrow transplants, chemo patients, and hodgkins lymphoma patients require (CMV, irradiated)

irradiated

what type ofHIV transfusions requre (CMV, irradiated)

normal

what defines massive haemorrhage

loss of blood volume in 24 hours // loss of 50% in 3 hours // 150ml.min

metabolic complications blood transfusion

hypothermia // hypocalaemia // hyperkalaemia // coagulopathy

what chromosome codes for ABO group

chromosome 9

what causes a non-haemolytic febrile reaction in blood transfusion

antibodies to cell fragments

symptoms non-haemolytic febrile reaction

fever and chills

mx non-haemolytic febrile reaction

slow or stop transfusion + paracetamol

what causes minor allergic reaction in blood transfusion

plasma protein

symptoms minor allergic reaction blood transfusion

itch, urticaria

mx minor allergic reaction blood transfusion

stop infusion + antihistamine

what is thought to cause anaphylaxis in blood transfusion

IgA deficiency

symptoms anaphylaxis

SOB, wheeze, angioedema, hypotension

mx anaphylaxis blood transfusion

stop transfusion + IM adrenaline + o2 + fluids

what causes acute haemolytic blood transfusion

ABO mismatch (IgM antibodies)

symptoms acute haemolytic reaction

fever, abdo pain, hypotension

mx acute haemolytic blood transfusion

stop, confirm patient, fluid rescuc + support

diagnosis acute haemolytic reaction

coombes

what causes Transfusion-associated circulatory overload (TACO)

excessive transfusion in pre-existing HF

symtpoms Transfusion-associated circulatory overload (TACO)

pulm oedema + HYPERtension

mx Transfusion-associated circulatory overload (TACO)

slow or stop transfusion // IV loops + O2

what causes Transfusion-related acute lung injury (TRALI)

non-cardiogenic pulm oedema

symptoms Transfusion-related acute lung injury (TRALI)

hypoxia, fever, HYPOtension

CXR Transfusion-related acute lung injury (TRALI)

pulm infiltrates

mx Transfusion-related acute lung injury (TRALI)

stop +O2

in infective blood transfusion reaction what causes it

CJD

what is GVHD

complication of bone marrow (or organ) transplant in immunosuppressed patients from T cells in the GRAFT

criteria for GVHD

bilingham: transplant as immune cells // recipient + donor are immunologically different // recipient immunocompromised

acute GVHD

within 100 days // skin eg painful maculopaular rash // jaundice // diarrhoea, N+V

chronic GVHD

100+ days // varied organ involvement // lung, eye, skin, GI

invx GVHD

LFT: raised ALP + bilir // abdo imaging // lung function