Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Transfusion Science > Chapter 15 Blood Components > Flashcards

Chapter 15 Blood Components Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

For blood collection what is a closed system versus an open system?

A

The blood collection set is sterile and considered a closed system
If ports or other areas are exposed to air, the system becomes an open system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is blood collected in?

A

Blood is collected in a primary bag containing anticoagulants and preservatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the bag whole blood is collected in? Name, made of, softened with, allows for, has in it, etc?

A

Whole blood is collected from the patient in a primary bag:
Made of polyvinyl chloride (PVC) softened with di-ethyl hexyl phthalate (DEHP)
Allows for gas exchange
Collected in anticoagulant
Primary bag is attached to a series of tubes and satellite bags that allow for the whole blood to be separated into its components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is done with the bag immediately after when the donation is complete?

A
  1. The unit is sealed off from potential contamination.
  2. Needle is hermetically sealed and removed
  3. Blood samples are collected from a diversion pouch for testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the ratio of anticoagulant to blood in the primary bag anticoagulant? Purpose?

A

Primary bag anticoagulant
1 part anticoagulant : 7 parts blood
Purpose:
Prevents clotting and extends storage
Volume of 70 mL to collect 480 +/- 45 mL whole blood (standard collection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What kind of anticoagulant mixture does CBS collect blood in? Name each component (4) and what they do?

A

CBS collects in CPD (citrate, phosphate, dextrose). Solution made up of:
1. Citric acid – inhibits glycolysis
2. Sodium citrate – prevents clotting
3. Sodium acid phosphate – maintain pH
4. Dextrose – source of energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long is whole blood good for? What is done at CBS?

A

Whole blood would only be good for 21 days and can only be given to group specific people. At CBS all units are divided into components.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is storage lesion?

A

Biochemical and morphologic changes during storage affect viability and function
a. Increased fragility
b. O2 carrying capacity reduced

Chemicals added can help prevent some of this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the changes to the blood/plasma in storage?

A

Increased plasma hemoglobin and K+.

Decreased viable cells, plasma pH, plasma Na+, RBC ATP, and 2,3 DPG.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the main components we get when we centrifuge a whole blood donation?

A

From one whole blood donation we can get different components by simply centrifuging the bag:
1. Red blood cells
2. Platelets
3. Plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Before a blood transfusion medically what should the doctor identify?

A

Before transfusion, the cause of the deficiency should be identified by a physician
a. Underproduction?
b. Production of a functionally defective component?
c. Excessive loss?
d. Increased destruction?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In general, what part of the blood component should be replaced in the patient?

A

The deficient component only should be replaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

After being centrifuged and filtered what level of WBC’s are guaranteed to be present in a unit?

A

Travel through a filter that captures WBC’s
Guaranteed to have:
< 5 x 10^6 WBC present in a unit
(usually down to < 0.2 x 10^6 WBC present in a unit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What additive does the satellite bag for red blood cells contain? List each component (4) and their purpose.

A

Satellite bag contains SAG-M (110mL)
This red cell additive increases the shelf life of the unit by reducing storage lesion
1. Saline – solvent/diluent
2. Adenine – substrate for red cell ATP synthesis
3. Glucose – source of energy
4. Mannitol – membrane stabilizer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the final product volume? How much is plasma and SAGM additive? Hct and Hgb levels?

A

Final product:
267 – 307 mL
Includes maximum 29 mL of plasma and 110 mL of SAGM additive
Hematocrit = 0.64 - 0.70L/L
Hemoglobin of ~ 55g/unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much should one unit of blood increase patients hemoglobin by in g/L?

A

Increases patients Hemoglobin by ~ 10g/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What symptoms can a reaction to leukocytes and their cytokines cause?

A
  1. Reactions to leukocytes can cause fever, shaking, and chills
  2. Cytokines produced by leukocytes can cause febrile reactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is used to remove leukocytes normally?

A

An in-line filter is used to remove leukocytes before storage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Does filtering leukocytes prevent graft-versus-host disease?

A

Removing leukocytes by filtration only does not prevent Graft-versus-Host Disease (GVHD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the normal shelf life of RBCs (Leukocyte reduced)?

A

1-6°C for 42 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the shelf life of RBCs (Leukocyte reduced) when the bag has been breached?

A

If bag is breached:
Transfused within 4 hours if stored above 6˚C
Transfused within 24 hours if maintained at 1-6˚C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How soon should a transfusion be initiated after removing the bag from the fridge and why?

A
  1. Transfusion should be initiated within 60 minutes once removed from the fridge (if at room temp)
  2. Risk of bacterial growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the contradictions for giving RBCs, Leukocyte reduced?

A
  1. Volume replacement or any other reason than correction of acute or chronic anemias where no other non-transfusion alternatives is available.
  2. There is no Hgb or Hct trigger
  3. There is a huge campaign for giving one unit at a time and re-evalutating (Choosing Wisely Canada)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the main purpose for giving RBCs, Leukocyte reduced?

A

Restoration of oxygen-carrying capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the indications for giving RBCs, Leukocyte reduced?

A

Indications:
1. Symptomatic anemia
a) Acute blood loss (accident, surgery)
b) Chronic anemia
c) Bone marrow suppression related to disease or medication
2. Should be ABO/Rh specific or compatible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

List 3 special red cell blood products that require special preparations?

A
  1. Washed
  2. Glycerolized Red Cells
  3. Irradiated Blood Products
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does washing do to the red cell blood product and its purpose?

A
  1. Removes traces of plasma and elements in it such as IgA, potassium, other cellular metabolites, additives, and cytokines
  2. Double wash for IgA-deficient recipient
  3. Prevents some adverse transfusion reactions in allergic and febrile non-hemolytic patients.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the “Washed” red cells washed with?

A

Washed with saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How long can the “Washed” red cells be stored for?

A

Stored at 1-6°C, transfuse within 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Who is Glycerolized red blood cells used for?

A

For rare blood group antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why is glycerol used for storing blood of rare blood group antigens?

A
  1. Glycerol is used as cryoprotectant. Otherwise RBCs develop crystals and will hemolyze once thawed
  2. Done so unit can be stored frozen for 10 years at -80°C
32
Q

How soon after collection does a unit need to be frozen for Glycerolized red blood cells?

A

Unit has to be frozen within 21 days from donation

33
Q

What is a caution that needs to be taken when using Glycerolized red blood cells?

A

Glycerol is toxic, so unit must be deglycerolized (washed) prior to transfusion

34
Q

What is a caution that needs to be taken when using Glycerolized red blood cells?

A

Glycerol is toxic, so unit must be deglycerolized (washed) prior to transfusion

35
Q

What is the process for deglycerolization? And storage temperatures for transfusing within 4 hours and 24 hours?

A
  1. After thawing, the unit is washed with a series of saline solutions to remove glycerol
  2. Stored at 1-6°C, transfuse within 24 hours
  3. Stored at R.T., transfuse within 4 hours
36
Q

What are irradiated blood products?

A

Products are filtered to remove WBCs, but this process doesn’t remove all WBCs
Units are subjected to gamma radiation
Destroy the viability of WBC

37
Q

What is the reason blood products are sometimes irradiated?

A
  1. Prevents TA-Graft-versus-Host Disease (GVHD) in immunocompromised patients
    Fetuses/Neonates
  2. Bone marrow transplant patients
  3. Also done in any directed donation from a blood relative
38
Q

What are the storage temperature and time limits for irradiated blood products?

A

Storage following irradiation:
1-6°C; 14 days post irradiation or 28 days post collection, which ever comes first

39
Q

What are the storage temperature and time limits for washed, extra washed and irradiated blood products?

A

Washed, extra washed & irradiated:
1-6°C; 48 hours post irradiation or original expiry date, which ever comes first

40
Q

What do pooled platelets, leukocyte reduced (LR), CPD consist of?

A

Pooled Platelets, Leukocyte Reduced (LR) CPD:
1. Buffy coats from whole blood collections from four different ABO matched donors are pooled in residual plasma from one male donor with 70mL of CPD (~340mL total)
2. Labelled with ABO/Rh and matched accordingly. If all pooled collections are Rh negative then it is Rh negative

41
Q

How many platelets, leukocytes are in a pooled platelet, LR, CPD unit?

A
  1. ~ 300 x 10^9 platelets per unit
  2. Leukocyte reduced by filtration to contain ~ 0.09 x 106 leukocytes per unit
42
Q

How long from collection are platelets pooled?

A

Pooled within 28 hours of collection

43
Q

What is platelets apheresis, Leukocyte reduced?

A
  1. Collected from a single donor
  2. 50 mL ACD-A in collection bag
  3. Take out the platelets and return the rest of the whole blood components to the donor
  4. Leukocyte reduced in the apheresis
  5. Labelled with ABO/Rh and matched accordingly
44
Q

What is ACD-A?

A

ACD – acid citrate dextrose- formula A (sodium citrate, citric acid and dextrose)

45
Q

What is the total volume, # of platelets, and leukocytes in a unit of apheresis platelets, LR?

A

~ 220 mL total volume
~333 x 10^9 platelets per unit
~ 0.07 x 10^6 leukocytes per unit

46
Q

What is the main purpose of giving platelets?

A

Action:
1. Maintain vascular integrity
2. Initiate formation of the platelet plug and stabilize it by contributing to fibrin formation

47
Q

What are the indications for use of platelets?

A

Indications for use:
1. Prevention or treatment of bleeding from thrombocytopenia or platelet function abnormality
a) Chemotherapy or irradiation
b) Postoperative bleeding

48
Q

How much can one unit of platelets increase a person’s platelet count by? Why may this not occur?

A

One unit increases the platelet count by 15 - 25 x 10^9 /L one hour post transfusion.

Often it does not raise it by that much due to sepsis, alloimmunization, fever, ITP, or DIC.

49
Q

What are the contradictions in the use of pooled platelets?

A
  1. Conditions that have rapid platelet destruction associated with:
    a) Immune Thrombocytopenic Purpura (ITP)
    b) Heparin-Induced Thrombocytopenia (HIT)
    c) Thrombotic Thrombocytopenic Purpura (TTP)
  2. Unless …. the patient has a life-threatening hemorrhage
50
Q

What are the storage requirements for pooled platelets?

A
  1. 20-24°C (RT) for up to 7 days
  2. Continuous gentle agitation during storage
  3. During transport can stop agitation for 24 hours
  4. Cultured for bacteria 36 hours after collection
  5. Only good for 4 hours once bag is breached
51
Q

What is the special condition required for pooled platelets to be issued to hospitals?

A

Units are issued to hospitals only if the culture is negative at the time of issue. If the component culture becomes positive after issue, the hospital is notified.

52
Q

What are the various plasma component products (5) that can be produced?

A

Plasma components:
1. Apharesis Fresh Frozen Plasma (AFFP)
2. Apheresis Frozen Plasma (AFP)
3. Frozen Plasma (FP)
4. Cryosupernatant Plasma (CSP)
5. Cryoprecipitate (cryo)

53
Q

What is the compatibility requirements for plasma component products?

A

Should be ABO compatible, does not need to be Rh matched

54
Q

What is Apheresis Fresh Frozen Plasma (AFFP)?

A

500mL of plasma collected in sodium citrate frozen at <-18°C within 8 hours after donation

55
Q

What is Apheresis Frozen Plasma ACD-A (AFP)?

A

250mL collected in ACD-A by apheresis and frozen at <-18°C within 24 hours after donation

56
Q

What is Frozen Plasma CPD (FP)?

A

290mL of plasma separated from one unit of CPD whole blood and frozen at <-18°C within 24 hours after donation

57
Q

What is Cryosupernatant Plasma CPD (CSP)

A

280mL of plasma prepared from slowly thawed FP that is centrifuged to separate the plasma from the insoluble cryoprecipitate. Cryoprecipitate is removed and the remaining plasma is refrozen at <-18°C

58
Q

What is Cryoprecipitate CPD (cryo)?

A

10mL of cryoprecipitate the insoluble portion once plasma is slowly thawed and centrifuged (like slush). Cryoprecipitate is refrozen at <-18°C .

59
Q

What therapeutic components does Apheresis Fresh Frozen Plasma (AFFP) contain?

A

All coagulation factors including V and VIII. VIII at 0.7 IU/mL or higher. (2021 average 1.05 IU/L)

60
Q

What is in Apheresis Frozen Plasma (AFP) and Frozen Plasma (FP)?

A

All coagulation factors but reduced amounts of factor V and VIII. VIII at 0.5 IU/mL or higher. (2021 average for AFP 1.05 IU/L and FP 0.9 IU/L)

61
Q

What is in Cryosupernatant Plasma
(CSP)?

A

All coagulation factors but reduced levels of high molecular weight von Willebrand’s factor, factor VIII, and fibrinogen (in the cryoprecipitate that was removed)

62
Q

What does Cryoprecipitate provide?

A

Provides a source of fibrinogen, coagulation factors VIII, XIII, and Von Willebrand’s factor. Fibronectin is also present

63
Q

Why is plasma collected in sodium citrate only good for 24 hours once thawed?

A

Plasma collected in sodium citrate is an open system. That is why it is only good for 24 hours once thawed.

64
Q

What is the main principle indication for AFFP, AFP and FP?

A

Treatment or Prevention of clinically significant bleeding due to a deficiency of one or more plasma coagulation factors for which more appropriate or specific alternative therapy is not available:

65
Q

What kind of patients (6) fit under the mandate for AFFP, AFP and FP use?

A
  1. Bleeding patients or patients undergoing invasive procedures who require replacement of multiple coagulation factors
  2. Patients with massive hemorrhage with clinically significant coagulation abnormalities
  3. Patients on warfarin who are bleeding or need to undergo an invasive procedure before vitamin K can reverse the warfarin effect
  4. Used to prepare “whole blood” for neonatal exchange transfusion
  5. Patents requiring treatment of TTP and HUS by plasma exchange
  6. Other conditions treated by therapeutic plasma exchange where the exchange fluid must include coagulation factors.
66
Q

What are the main contradictions for the use of AFFP, AFP, FP and CSP?

A
  1. Volume replacement alone or for a single coagulation factor deficiency if specific recombinant products are available.
  2. Hypovolemia can be treated with 0.9% sodium chloride, Ringer’s lactate solution or albumin.
  3. Do not use CSP for conditions that require fibrinogen, factor VIII or Von Willebrand factor replacement (in the cryoprecipitate – none left in the cryosupernatant)
67
Q

Who is Octaplasma used for?

A
  1. For use in a limited number of patients who meet specific criteria
  2. May help reduce adverse events linked to residual blood cells, like TRALI
  3. Helps reduce transmission of viruses
68
Q

How is Octaplasma derived? Volume of units?

A
  1. Solvent detergent treated, pooled fresh frozen plasma
  2. Filtered after to remove cells and debris
  3. Units are 200 mL
69
Q

What is Convalescent plasma? Where has it been used?

A

Plasma that has been collected from people that have recovered from an infection and their plasma contains neutralizing antibodies against the causative pathogen.

Has been used as an experimental therapy to treat SARS, H1N1, Ebola and most recently COVID-19.

Research still being done – nothing conclusive

70
Q

What is the procedure to thaw frozen plasma?

A
  1. Thaw at 30-37 °C for 20 to 30 minutes
  2. 10 minutes for cryoprecipitate
  3. Cannot put back in the freezer once it has been thawed
  4. Frozen bags are fragile

See slide 46 for pic of waterbath equipment used.

71
Q

What are Fractionated Plasma products?

A

Commercial agencies use plasma to create other products by fractionating the plasma.

72
Q

What kind of fractionated plasma products are created (6) and their common usages?

A
  1. Albumin, 5% and 25% - Volume Replacement
  2. Immune Serum Globulin - Immune deficiencies, etc.
  3. RH Immune Globulin (RhIG) - Prevent alloimmunization of D antigen.
  4. Hepatitis B Immune Globulin (HBIG) - Prophylasix for individual w/o known anti-HBs following needlestick injury
  5. Factor VIII Concentrate - Hemophiliacs with def.
  6. Factor IX Complex - Hemophilias w/ def.

And many more…

73
Q

What product is their for to treat coagulation factor deficiencies?

A

Coagulation factor concentrates
- Over 20 products avail.
- See slide 49 for more details.

74
Q

What are the transportation requirements for blood products for whole blood/RBCs, frozen units, and platelets?

A
  1. Whole blood or RBCs should be kept at 1° to 10°C
  2. Frozen units are shipped on dry ice
  3. Platelets are maintained at 20°-24° C
75
Q

What protective devices should storage equipment for blood products have?

A

Refrigerators, freezers, and platelet incubators should have
1. Recording devices
2. Audible alarms
3. Alarm checks
4. Emergency backup procedures
5. Calibrated thermometers

76
Q

What should stored blood be examined for?

A

Stored blood should be examined for hemolysis and abnormal color or clots

Review visual assessment guide on LEARN

Transfusion Science (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions