Chapter 3 - Blood Products Flashcards
Which blood products do not carry the risk of HIV and hepatitis?
Albumin and serum globulins (because they are heat treated)
When do you use CMV-negative blood?
In low-birth-weight infants, bone marrow transplant patients, other transplant patients
What is the #1 cause of death from transfusion reactions?
Clerical error leading to ABO incompatibility
What is an acute hemolysis reaction caused by/what are the symptoms?
ABO incompatibility, antibody mediated; back pain, chills, tachycardia, fever, hemoglobinuria. Can lead to ATN, DIC, shock. In anesthetized pts may present as diffuse bleeding.
What is the treatment for acute hemolysis reaction?
Fluids, diuretics, HCO3-, pressors, histamine blockers (benadryl)
What is delayed hemolysis reaction caused by?
Antibody-mediated against minor antigens
What is the treatment for delayed hemolysis reaction?
Observation if stable
What is nonimmune hemolysis caused by?
Squeezed blood
What is the treatment for nonimmune hemolysis?
Fluids and diuretics
What is the most common transfusion reaction?
Febrile nonhemolytic transfusion reaction
What is febrile nonhemolytic transfusion reaction caused by?
Recipient antibody reaction against WBCs in donor blood
What is the treatment for febrile nonhemolytic transfusion reaction?
d/c transfusion, use WBC filters for subsequent transfusions
What is anaphylaxis due to transfusion caused by?
Usually IgG against IgA in IgA-deficient recipient
What is the treatment for anaphylaxis from transfusion?
Fluids, lasix, pressors, steroids, epinephrine, histamine blockers (benadryl)
What is the cause of urticaria from transfusions?
Nonhemolytic, usually a reaction against plasma proteins or IgA in the transfused blood
What is the treatment for urticaria from transfusions?
Histamine blockers (benadryl), supportive
After how many units of PRBCs will you see dilutional throbocytopenia?
10
What electrolyte abnormality will you see after massive transfusion?
Hypocalcemia - Ca required for clotting cascade
What is the incidence and when will people develop antiplatelet antibodies?
In 20% of patients after 10-20 platelet transfusions
What is TRALI caused by?
Antibodies to recipient’s WBCs, clot in pulmonary capillaries
What is the most common bacterial contaminate?
GNR (usually E. coli)
What is the most common blood product source of contamination?
Platelets (because they’re not refridgerated)
What is the risk of transfer of HIV with transfusion?
1: 1-2 million
What is the risk of transfer of Hepatitis B or C with transfusion?
1: 250-500 thousand
