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CVPR 330 Blood > Component Therapy / Test 3/3 > Flashcards

Component Therapy / Test 3/3 Flashcards

1
Q

What is the concept of component administration ?

A

use particular component for specific need

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2
Q

What ate the advantages of specific component administration ?

A

conserve blood, facilitate optimum treatment

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3
Q

Blood can be separated into what other components?

A

Packed cells
Plasma
Platelets
Cryoprecipitate

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4
Q

WHOLE BLOOD

A
  • Approximately 400-550 ml plus
  • 63 ml of CPD (anticoagulant)
  • Hematocrit (HCT) – 36-44%
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5
Q

WHOLE BLOOD is stored at 1-6 C.

What beomes non functional ?

What factors decrease during storage?

A

platelets/granulocytes

Factors V and VIII

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6
Q

What are 3 Indications for Whole Blood ?

A
  • Oxygen-carrying capacity / blood volume expansion
  • Stable coagulation factors.
  • Actively bleeding with > 25% blood loss
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7
Q

What is the best solution of the storage of whole blood ?

A

CPDA – 35 day outdate

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8
Q

Dose and administration of whole blood (adult) & (Peds)?

A

1g/dL Hgb or 3% Hct increase (adults)

8mL/kg – 1g/dL Hgb increase (peds)

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9
Q

Whole blood must be Administered through a blood filter within ?

A

4 hrs

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10
Q

Hematocrit of the donor unit is ?

A

60%

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11
Q

Dose and administration of whole blood (neonates?

A

10 – 15 mL/kg will increase the hemoglobin by about 3 g/dL

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12
Q

RED BLOOD CELLS Prepared from whole blood: What is the Hct range for (AS red cells) ?

A

(Hct 50-65%)

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13
Q

RED BLOOD CELLS Prepared from whole blood: What is the Hct range for (CPDA-1) & (CPD) ?

A

(Hct 65-80%)

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14
Q

What is the residual plasma content in RBC units?

A

~20 – 120 mL

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15
Q

Why would you transfuse RBCs ??

A

Increase oxygen carrying capacity and red cell mass

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16
Q

General guidelines for RBC transfusion for patients that have a Hgb > 10g/ml ?

A

increased oxygen consumption, e.g. sepsis

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17
Q

Signs and symptoms supporting need for transfusion

of RBC ?

A
  • Syncope
  • Angina
  • dyspnea
  • Tachycardia
  • Rapid fall in Hgb (active bleeding)
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18
Q

Medical condition influencing need for transfusion of RBCs ?

A
  • CHF
  • Coagulopathy,
  • DIC
  • Acquired or congenital anemias
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19
Q

You should NEVER hang RBCs with what other infusions ?

A
  • D5W,
  • LACTATED RINGERS OR
  • MEDICATIONS
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20
Q

What other infusions CAN you hang RBCs with ?

A
  • NS,
  • albumin or
  • plasmanate
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21
Q

In Order to transfuse RBCs ABO and Rh must be compatible, you should transfuse over a period of ?

A

4 hrs with a filter

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22
Q

Regular PRBCs contain how many WBC ?

A

1-3x 10^9 WBC/unit

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23
Q

Leukoreduced units must retain what percentage of RBCs after filtration?

A

85%

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24
Q

3 reasons of why we should use Leukoreduced PRBCs ?

A
  • Prevent febrile nonhemolytic reactions
  • Reduce HLA alloimmunization
  • Prevent TA-CMV infection
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25
Q

Some patients may actually produce leukoagglutinins after many transfusions or just a few. The patient produces antibodies that will bind to the transfused leucocytes and the resulting complexes bind to and activate monocytes which release what?

A

cytokines with pyrogenic properties.

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26
Q

RED BLOOD CELLSWASHED with NS ?

A 
70-80% Hct
98% plasma free
Reduced leukocytes, platelets
24 hour shelf life
10-20% red cell loss
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27
Q

Why would we transfuse washed RBCs ?

A

Prevent recurrent/severe allergic reactions to plasma proteins

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28
Q

When RED BLOOD CELLS are Frozen and deglycerolized for Long term preservation
what do we add as a cryoprotectant ?

A

glycerol

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29
Q

When RED BLOOD CELLS are Frozen and deglycerolized they can be stored at -65 c for how long ?

A

10 yrs

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30
Q

When RED BLOOD CELLS have been Frozen and deglycerolized, and now we need to use them, what do we do ?

A

-Thaw and wash with saline/glucose solution

  • Maintain 70-80% Hct
  • 24 hour shelf life
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31
Q

IRRADIATED Blood Products gamma rays, cobalt-60, or x-rays produced by radiation, renders the T lymphocytes inactive. How many RADS are delivered to the units ?

A

2500 - 3000

32
Q

What is the shelf life of IRRADIATED Blood Products?

A

28 days

33
Q

When would you consider it necessary to use IRRADIATED Blood Products ?

A
  • Prevent GVHD
  • Intrauterine transfusions
  • Neonates
34
Q

What cellular components do

Irradiated products include ?

A

Platelets

Red blood cells

35
Q

Serologically screened negative for CMV antibody is the definition for what word ?

A

Seronegative

36
Q

What products are CMV safe ?

A

Leukoreduced

37
Q

What is the risk of CMV transmission from a seropositive unit ?

A

0.3 %

38
Q

Why would we administer CMV NEGATIVE or CMV SAFE units ?

A
  • Prevent TA-CMV infection
  • CMV seronegative mother
  • Bone marrow transplant recipients
  • Solid organ transplants
39
Q

What is the platelet count that we can generate from concentrating one 50 ml whole blood unit ?

A

5.5 x 10^10 plts/unit

40
Q

What is the shelf life of platelets stored at RT with constant agitation ?

A

5 days

41
Q

What platelet count can we achieve from a single donor through APHERESIS ?

A

~3x10^11 plts/unit (200-400 ml)

42
Q

What 2 things must we consider when administering donor platelets ?

A

ABO compatible preferred

Irradiation to prevent GVHD

43
Q

Pool of 5 units or 1 apheresis platelet will raise the platelet count by how much?

A

25,000 – 50,000 µL

44
Q

Normal adult platelet count =

A

150,000 – 400,000

45
Q

What is caused by bleeding, fever, sepsis, DIC, medications, or splenomegaly ?

How can we fix this ?

A

refractoriness

Leukoreduction

46
Q

FRESH FROZEN PLASMA should be Separated and frozen within ?

Volume ?

Stored at ?

A

8 hours of collection

200-250 ml/unit

-18C for up to 1 yr

47
Q

Plasma frozen within 24 hours of collection (FP24) has

Reduced levels of what ?

A

Factor V and VIII

48
Q

Once thawed FFP** and FP24 are good for how long ?

A

5 days

49
Q

Once thawed FFP** and FP24’s

Factor VIII and Factor V activity are at their highest levels within ?

A

24 hrs

50
Q

Under what circumstances should we consider administering Thawed Plasma:FFP or FP24 ?

A
  • Bleeding
  • Multiple coagulation deficiencies
  • Congenital factor deficiency
  • No factor concentrate available
51
Q

Thawed Plasma:FFP and FP24 is not indicated for what purposes ?

A
  • hemophilia,
  • nutritional support or
  • volume expansion
52
Q

Thawed Plasma:FFP and FP24 Dose is calculated to achieve a minimum of ?

A

30% of plasma factor concentration (~10-20 mL.kg)

53
Q

universal plasma recipient

A

O

54
Q

universal plasma donor

A

AB

55
Q

Thawed Plasma ABO compatibility ?

A

A,B,O, AB

56
Q

What shoulf you monitor for after Plasma administration ?

A

Pro-time and aPTT (INR)
or
specific factor assay

57
Q

Cryoprecipitate is Separated from frozen – thawed plasma that has been frozen -18 C for up to one year.

What does it contain ?

A 
Factor VIII (80  IU)
Fibrinogen (150 mg)
vWF (vonWillibrand’s factor)
Factor XIII
Fibronectin
58
Q

For patients that are in need of Fibrinogen, or that suffer from vonWillibrand disease or Hemophilia A (factor VIII), we should treat them with ?

A

CRYOPRECIPITATE

59
Q

1 unit of CRYOPRECIPITATE increase fibrinogen by how much ?

A

5 mg/dL (adult)

60
Q

Dose for CRYOPRECIPITATE ?

A

1 unit per 7 – 10 kg body wt

  • ABO compatible preferred but not necessary
  • Given in pools of 10 for adult dose
61
Q

Developed for use to bypass antibodies against Factor VIII in hemophilia A patients
Used for Factor VII deficiency
Used in massive transfusion cases for procoagulant deficiency and achievement of hemostasis

A

Activated Factor VIIa

62
Q

What drug is Used for expanding plasma volume ?

A

Albumin: 5%

63
Q

What medication Restores plasma volume and

prevents deep vein thrombosis ?

A

Dextrans

64
Q

What drug has an equivalent plasma volume expansion to albumin but may increase post-op bleeding ?

A

Hydroxyethyl starch (HES)

65
Q

Blood components are transfused through a standard filter that measures ?

A

(170-260-micron filter)

66
Q

Transfusion must be completed within ___ of time it is signed out of the blood bank.

A

4 hrs

67
Q

No medications or solution other than 0.9% NaCL injection (USP) should be administered with blood components through the same tubing. Solutions containing dextrose alone may cause what ?

A

red cells to swell and lyse

68
Q

Lactated ringer’s solution or other solutions containing high levels of Ca may overcome the buffering capacity of the citrate anticoagulant in the blood preservative solution and cause what ?

A

clotting of the component

69
Q

Adverse Reactions to Transfused Blood Components ?

A
  • Allergic (anaphylactic)
  • Febrile
  • Transfusion associated circulatory overload
  • Transfusion Related Acute Lung Injury
  • Acute Hemolytic Transfusion Reaction
  • Intravascular Hemolysis
70
Q

During an Anaphylactic reaction due to transfused IgA in a recipient that is IgA deficient, we can expect what type of symptoms ?

A

Severe hypotension, mild hives

1.1 – 3 % occurrence

71
Q

Transfusion-related acute lung injury (TRALI) results from ?

A
  • Transfusion of Donor Human leukocyte antigen (HLA) antibodies
  • Recipient reaction
72
Q

Transfusion-related acute lung injury (TRALI) results from ?

A
  • Transfusion of Donor Human leukocyte antigen (HLA) antibodies
  • Recipient reaction
73
Q

What signs and symptoms can we expect from Transfusion-related acute lung injury (TRALI) ?

A

Chills, fever, non-productive cough, hypo- or hypertension within 1-2 hours transfusion
Pulmonary inflammation, accumulation of neutrophils and edema.

74
Q

ABO incompatible transfusion of donor; antigen

Recipient antibodies destroy RBC Intravascularly. As a result ___ of all fatal acute hemolytic reactions

A

3/4

75
Q

What happens during an Acute Hemolytic Transfusion reaction ?

A
  • Plasma hemolysis increases
  • Urine free hemoglobin increases
  • Decrease in circulating haptoglobin

That ultimately leads to . .

Shock
DIC
Renal failure

76
Q

General guidelines for RBC transfusion for patients that have a Hgb

A
  • Symptomatic
  • Recent/active bleeding
  • Hx of cerebro/cardiovascular -disease

CVPR 330 Blood (25 decks)

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