Chapter 3: Blood Products

Question 1

All blood products carry the risk of HIV and hepatitis except..

Answer 1

Albumin and serum globulins (theses are heat treated)

Question 2

What is donated blood screened for?

Answer 2

HIV. HepB. HepC. HTLV. Syphillis. West Nile virus.

Question 3

When would you use CMV-negative blood?

Answer 3

Low birth-weight infants. Bone marrow transplant patients. Other transplant patients.

Question 4

Stored blood: left or right shift on O2 dissociation curve?

Answer 4

Left shift: stored blood is low in 2,3-DPG. (has increased affinity for oxygen).

Question 5

Three types of hemolytic reactions from blood transfusion

Answer 5

• Acute hemolysis
• Delayed hemolysis
• Nonimmune hemolysis

Question 6

Acute hemolysis

Answer 6

Transfusion reaction:
ABO incompatibility; antibody mediated.

S/S: back pain, chills, tachycardia, fever, hemoglobinuria.
Can lead to ATN, DIC, shock.
Tx: fluids, diuretics, HCO3-, pressors, antihistamines

Question 7

Diagnosis of acute hemolysis from transfusion reaction

Answer 7

Haptoglobin 5g/dL, increase in unconjugated bilirubin

Question 8

How does acute hemolysis from blood transfusion present in anesthetized patients?

Answer 8

Diffuse bleeding

Question 9

Delayed hemolysis

Answer 9

Transfusion reaction:

• Antibody-mediated against minor antigens.
• Tx: observe if stable

Question 10

Nonimmune hemolysis

Answer 10

Transfusion reaction:
- From squeezed blood.
Tx: fluids and diuretics

Question 11

Febrile nonhemolytic transfusion reaction

• Use WBC filters for subsequent transfusions

Answer 11

Transfusion reaction:
Usually recipient antibody reaction against donor WBCs
Tx: discontinue transfusion

Question 12

Anaphylaxis

Answer 12

Transfusion reaction:
Usually recipient antibodies against donor IgA in an IgA-deficient patient.
S&S: bronchospasm, hypotension, urticaria.
Tx: fluids, Lasix, pressors, steroids, epinephrine, antihistamines

Question 13

Transfusion-related acute lung injury (TRALI)

Answer 13

Transfusion reaction:

Caused by donor antibodies to recipient’s WBCs, clot in pulmonary capillaries

Question 14

When does dilution thrombocytopenia occur with blood transfusion?

Answer 14

Occurs after 10 units of PRBCs

Question 15

What is the problem with hypocalemia with clotting?

Answer 15

Can cause poor clotting. Occurs with massive transfusion, Ca is required for the clotting cascade

Question 16

MC bacterial contaminate

Answer 16

GNRs (usually E. coli)

Question 17

MC blood product source of contamination

Answer 17

Platelets (not refrigerated)

Question 18

Can be transmitted with blood transfusion (sleeping sickness)

Answer 18

Chaga’s disease