Blood Transfusions and Blood Components (Angelina L. Mirasol, MD) Flashcards
Also known as the Blood Services Act of 1994
RA 7719
What does RA 7719 emphasize?
Voluntary and non-profit collection of blood
Blood donation as a humanitarian act
Provide safe, affordable and equitable distribution of blood
What must each blood unit be labelled with?
ABO and RhD group
Risks associated with allogenic red cell transfusion
Transfusion reactions
Disease transmission
Immunomodulation
Detection, data gathering and analysis of adverse events of blood transfusion
Hemovigilance
When should blood transfusion be performed?
When the required tests are done and the benefits outweigh the risks
T/F: If possible, transfuse blood components rather than whole blood.
True
When is informed consent for transfusion not needed?
Life-threatening emergencies
Allows single blood donation to provide treatment for several patients
Fractionation of blood
Blood component that transmits most of the infections present in whole blood
Plasma
Composition of whole blood
Hct 40% / 570 mL
Indications for the use of whole blood
Symptomatic anemia with large volume deficiet (except severe chronic anemia)
Loss of both RBC and plasma volume
Viability of Pakced Red Blood Cells (PRBCs)
35 days (stored in CPDA-1) to 42 days (stored in AS)
Composition of PRBC
Hct 55 - 70% / 330 mL
Indications for use of PRBC
Symptomatic anemia
Hgb < 7 g/dl or Hct <21%
Examples of red blood cell substitutes
Fluorocarbon-based synthetic oxygen carriers
Stroma free, cross-linked or polymerized human or nonhuman hemoglobin preparation
When are red blood cell substitutes useful?
Acute massive blood loss (trauma or major operation)
Patients declining transfusion for religious reasons
Contraindications to RBC transfusion
- Volume expansion when oxygen carrying capacity is adequate
- Prophylaxis w/o symptoms of anemia
- Enhance sense of well-being
- Promote wound healing
Indications for platelet transfusion therapy
Therapeutic
Prophylactic
Guidelines for platelet transfusion
P1 - Count <100,000
P5 - Massive transfusion with diffuse microvascular bleeding
P6 - Others
Appropriate dose for platelet transfusion therapy
1 unit/10 kg body weight (max 8 units)
Disorders where platelet transfusion is not useful
Drug induced thrombocytopenia Thrombotic thrombocytopenia purpura Hemolytic-uremic syndrome Idiopathic thrombocytopenia purpura Heparin induced thrombocytopenia Conditions where platelets are destroyed or not activated
Usual adult dose of random donor platelets
6 units
What increment is expected to be achieved following transfusion with random donor platelets?
30,000/uL (each unit expected to raise platelet count by 5,000/uL)
Risk of using random donor platelets
Associated with septic reaction due to storage at room temperature
Expected post-transfusion platelet increased from 1 unit of SDP/Apheresed platelets
30,000 uL
Adult dose of fresh frozen plasma
10 - 20 mL/kg body weight
Standard Dose: 4 - 6 units
Expected increase in coagulation factor levels after administration of fresh frozen plasma
20%
Shelf life of fresh frozen plasma, cryoprecipitate and cryosupernate
1 year when frozen at -30 degrees Celsius
Indications for use of fresh frozen plasma
Control or prevention of bleeding in multiple coagulation defects
Fraction of plasma proteins precipitated when FFP is thawed at 4 degrees Celsius
Cryoprecipitate
Components of the cryoprecipitate
VIII, VWF, XIII, fibrinogen, and fibronectin
Adult dose of cryoprecipitate
10 - 20 units
Note: 1 unit/10kg increases fibrinogen by 7 - 10 mg/dL
Indications for use of cryoprecipitate
Hemophilia A with bleeding or anticipated surgery
Von Willebrand Disease
Fibrinogen deficiency
Factor XIII deficiency
Indications for use of cryosupernate
Hemophilia B with bleeding or anticipated surgery
Factor II, VII or X deficiency
Hemorrhage due to coumadin-type drugs
Adult dose of cryosupernate
1 unit/10 kg BW
Most common cause of acute transfusion reactions
Transfusion of incompatible blood component
T/F: Under no circumstances should blood be stored outside for more than 1 hour prior to transfusion.
False
The limit is 30 minutes. No more than 30 mins!
