Blood Transfusions and Blood Components (Angelina L. Mirasol, MD)

Question 1

Also known as the Blood Services Act of 1994

Answer 1

RA 7719

Question 2

What does RA 7719 emphasize?

Answer 2

Voluntary and non-profit collection of blood
Blood donation as a humanitarian act
Provide safe, affordable and equitable distribution of blood

Question 3

What must each blood unit be labelled with?

Answer 3

ABO and RhD group

Question 4

Risks associated with allogenic red cell transfusion

Answer 4

Transfusion reactions
Disease transmission
Immunomodulation

Question 5

Detection, data gathering and analysis of adverse events of blood transfusion

Answer 5

Hemovigilance

Question 6

When should blood transfusion be performed?

Answer 6

When the required tests are done and the benefits outweigh the risks

Question 7

T/F: If possible, transfuse blood components rather than whole blood.

Answer 7

True

Question 8

When is informed consent for transfusion not needed?

Answer 8

Life-threatening emergencies

Question 9

Allows single blood donation to provide treatment for several patients

Answer 9

Fractionation of blood

Question 10

Blood component that transmits most of the infections present in whole blood

Answer 10

Plasma

Question 11

Composition of whole blood

Answer 11

Hct 40% / 570 mL

Question 12

Indications for the use of whole blood

Answer 12

Symptomatic anemia with large volume deficiet (except severe chronic anemia)
Loss of both RBC and plasma volume

Question 13

Viability of Pakced Red Blood Cells (PRBCs)

Answer 13

35 days (stored in CPDA-1) to 42 days (stored in AS)

Question 14

Composition of PRBC

Answer 14

Hct 55 - 70% / 330 mL

Question 15

Indications for use of PRBC

Answer 15

Symptomatic anemia

Hgb < 7 g/dl or Hct <21%

Question 16

Examples of red blood cell substitutes

Answer 16

Fluorocarbon-based synthetic oxygen carriers

Stroma free, cross-linked or polymerized human or nonhuman hemoglobin preparation

Question 17

When are red blood cell substitutes useful?

Answer 17

Acute massive blood loss (trauma or major operation)

Patients declining transfusion for religious reasons

Question 18

Contraindications to RBC transfusion

Answer 18

1. Volume expansion when oxygen carrying capacity is adequate
2. Prophylaxis w/o symptoms of anemia
3. Enhance sense of well-being
4. Promote wound healing

Question 19

Indications for platelet transfusion therapy

Answer 19

Therapeutic

Prophylactic

Question 20

Guidelines for platelet transfusion

Answer 20

P1 - Count <100,000
P5 - Massive transfusion with diffuse microvascular bleeding
P6 - Others

Question 21

Appropriate dose for platelet transfusion therapy

Answer 21

1 unit/10 kg body weight (max 8 units)

Question 22

Disorders where platelet transfusion is not useful

Answer 22

Drug induced thrombocytopenia
Thrombotic thrombocytopenia purpura
Hemolytic-uremic syndrome
Idiopathic thrombocytopenia purpura
Heparin induced thrombocytopenia
Conditions where platelets are destroyed or not activated

Question 23

Usual adult dose of random donor platelets

Answer 23

6 units

Question 24

What increment is expected to be achieved following transfusion with random donor platelets?

Answer 24

30,000/uL (each unit expected to raise platelet count by 5,000/uL)

Question 25

Risk of using random donor platelets

Answer 25

Associated with septic reaction due to storage at room temperature

Question 26

Expected post-transfusion platelet increased from 1 unit of SDP/Apheresed platelets

Answer 26

30,000 uL

Question 27

Adult dose of fresh frozen plasma

Answer 27

10 - 20 mL/kg body weight

Standard Dose: 4 - 6 units

Question 28

Expected increase in coagulation factor levels after administration of fresh frozen plasma

Answer 28

20%

Question 29

Shelf life of fresh frozen plasma, cryoprecipitate and cryosupernate

Answer 29

1 year when frozen at -30 degrees Celsius

Question 30

Indications for use of fresh frozen plasma

Answer 30

Control or prevention of bleeding in multiple coagulation defects

Question 31

Fraction of plasma proteins precipitated when FFP is thawed at 4 degrees Celsius

Answer 31

Cryoprecipitate

Question 32

Components of the cryoprecipitate

Answer 32

VIII, VWF, XIII, fibrinogen, and fibronectin

Question 33

Adult dose of cryoprecipitate

Answer 33

10 - 20 units

Note: 1 unit/10kg increases fibrinogen by 7 - 10 mg/dL

Question 34

Indications for use of cryoprecipitate

Answer 34

Hemophilia A with bleeding or anticipated surgery
Von Willebrand Disease
Fibrinogen deficiency
Factor XIII deficiency

Question 35

Indications for use of cryosupernate

Answer 35

Hemophilia B with bleeding or anticipated surgery
Factor II, VII or X deficiency
Hemorrhage due to coumadin-type drugs

Question 36

Adult dose of cryosupernate

Answer 36

1 unit/10 kg BW

Question 37

Most common cause of acute transfusion reactions

Answer 37

Transfusion of incompatible blood component

Question 38

T/F: Under no circumstances should blood be stored outside for more than 1 hour prior to transfusion.

Answer 38

False

The limit is 30 minutes. No more than 30 mins!