(F) Preparation of Blood Component, Storage, Transport, Indication for transfusion Flashcards
Familiarize the goals in blood collection
- Maintain viability and function
- Prevent physical changes
- Minimize bacterial contamination
- Practice good manufacturing practice (GMP)
Matching type
a. Maintain viability and function
b. Prevent physical changes
c. Minimize bacterial contamination
d. Practice good manufacturing practice (GMP)
- The storage of blood unit should be considered
- This is done especially during collection and component preparation
- Prevention of bacterial contamination starts from the collection of blood
- The blood unit should be viable until the time it is transfused to the patient
- b
- d
- c
- a
Considerations in blood collection
- Blood units should be collected based on the time
allotted. The ideal time of collection is ____minutes or
maximum of____ only. - ____ should be minimized as much as possible
during collection, especially to the tissues that would probably alter and render blood products not fit for transfusion.
* If a collection is past 15 minutes, it would affect the coagulation factors and it can’t be processed anymore to ____* - Blood should be collected by a ____ only. Gentle mixing and the choice of anticoagulant should be monitored.
- Blood units should be collected based on the time
allotted. The ideal time of collection is** 4-10** minutes or maximum of 15 minutes only. -
Trauma should be minimized as much as possible during collection, especially to the tissues that would probably alter and render blood products not fit for transfusion.
* * If a collection is past 15 minutes, it would affect the
coagulation factors and it can’t be processed anymore
to fresh frozen plasma (FFP). - Blood should be collected by a single venipuncture only. Gentle mixing and the choice of anticoagulant should be monitored.
Changes that occur during storage
- Shelf life is synonymous with ____
- An accepted criterion for maintenance of viability and function during storage (RBC) is that at the end of the expiration, at least ____ of the original red cells should be in the recipient’s circulation 24 hours after transfusion.
- Shelf life is synonymous with expiration date.
- An accepted criterion for maintenance of viability and function during storage (RBC) is that at the end of the expiration, at least 75% of the original red cells should be in the recipient’s circulation 24 hours after transfusion.
storage lesions or biochemical changes
- Biochemical changes occuring during storage at ____, called as ____
- It can affect the oxygen dissociation curve, causing an (increased / decreased) affinity for oxygen
- Biochemical changes occuring during storage at 1-6C, called as storage lesion
- It can affect the oxygen dissociation curve, causing an increased affinity of hemoglobin for oxygen
storage lesions or biochemical changes
- (high / low) 2,3-DPG, (increased / decreased) O2 affinity => less O2 released to the red cells
- pH (increases / decreases) due to lactic acid production causing 2,3-DPG levels to fall
- Once transfused, RBCs (regenerate / destroy) ATP and 2,3-DPG
- low 2,3-DPG, increased O2 affinity => less O2 released to the red cells
- pH decreases due to lactic acid production causing, 2,3=DPG levels to fall
- Once transfused, RBCs regenerate ATP and 2,3-DPG
Storage lesions or biochemical changes
- There will be few functional platelets present. Note that the storage platelets should be at ____, thus, if they are stored at 1-6C, there will be no more viable platelets
- Viable or living RBCs ______
- There will be few functional platelets present. Note that the storage platelets should be at room temperature, thus, if they are stored at 1-6C, there will be no more viable platelets.
- Viable or living RBCs decrease
Storage lesions or biochemical changes
Increase or decrease?
- Plasma Na+
- Plasma K+
- Plasma Hgb
- decrease
- increase
- increase
storage lesions or biochemical changes
- pH
- 2,3-DPG levels
- ATP level
- Ammonia
- decrease
- decrease
- decrease
- increase
Identify:
prevents blood clotting and provides nutrients for the cells
Anticoagulants
Match the anticoagulant to the action
a. citrate
b. dextrose
c. phosphate
d. adenine
e. mannitol
- Membrane stabilizing agent
- Protection against events storage-related hemolysis
- Acts as a buffer
- e
- e
- c
Match the anticoagulant to the action
a. citrate
b. dextrose
c. phosphate
d. adenine
e. mannitol
- a.k.a. Glucose, provides energy to red cell
- Substrate for random blood sugar (RBS) synthesis of ATP
- Binds Ca2+, prevents coagulation
- b
- d
- a
In adding the ADSOL, you first have to centrifuge the whole blood and remove ____ within ____ hours
remove platelet rich plasma (PRP)
within 72 hours
Additive solution
Once PRP is separated from the red cells, you can add additive solution or ADSOL to ____ only, extending the storage up to ____ days
you can add ADSOL to RBCs only, extending the storage up to 42 days
ADSOL is composed of?
- Adenine
- Dextrose (or glucose)
- Sodium Chloride / saline
- Mannitol
Additive Solution
There will be a change in the hematocrit since additional
solutions have been incorporated which has a volume of
around ____. Final hematocrit of the unit would
decrease approximately ____.
But with a normal packed RBC (without additive
solutions), hematocrit would be ____.
There will be a change in the hematocrit since additional
solutions have been incorporated which has a volume of
around 100 mL. Final hematocrit of the unit would
decrease approximately **50 – 60%. **
- But with a normal packed RBC (without additive
solutions), hematocrit would be 70 to 80%.
Preparation of blood components
Blood from a donor is collected into a ____
and ____ to be processed into different
components.
Blood from a donor is collected into a system of tubings
and satellite containers to be processed into different
components.
Preparation of blood components
Collect within ____ minutes to prevent the activation of the coagulation system
If more than this amount , the collected unit cannot be processed to ____ or ____
Collect within 15 minutes, the collected unit cannot be processed to fresh frozen plasma (FFP) or Cryoprecipitate
Preparation of blood components
Draw the blood into the mother bag using a ____ primary bag with satellite bags, making sure that the hermetic seal is intact
closed system primary bag
Preparation of blood components
If hermetic seal is broken, it is now considered as an ____ and the blood should be transfused within ____ hours if stored at 1-4C
If stored at 20C to 24C, transfuse within ____ hours
If hermetic seal is broken, it is now considered as an open system and the blood should be transfused within 24 hours hours if stored at 1-4C
If stored at 20C to 24C, transfuse within 4 hours
One unit of whole blood can produce
- Packed RBCs
- FFP
- Cryoprecipitate
- Single donor plasma
- Platelets
FFP can be processed to which components?
- cryoprecipitate
- single donor plasma
What are the three critical variables in preparation of blood components through centrifugation?
- rotor size
- speed
- duration
What is the principle involved in separating blood components
centrifugation
What are the two equipments needed for blood component separation through centrifugation?
- refrigerated centrifuge
- sterile docking device (joins tubing)
Identify the equipment being described
This is used by placing the segment of the mother
bag on one end and the segment of the satellite bag
to the other end and locking the system before
pressing start on the machine. The tubes will then be
welded into one, thereby, imitating a closed system.
sterile docking device
What does the greek word “hermes” mean
the exit or entry of air
this is synonymous to a closed system and is prevented from being broken to maintain the closed system
hermetic seal
T or F
- Centrifuge the blood using a heavy spin to keep the platelets suspended in the plasma
- REmove the platelets suspended in plasma or platelet rich plasma (PRP) from the red cells -> packed RBCs
- If citrate phosphate dextrose (CPD) is used, packed RBCs can be stored up to 21 days
- if ADSOL is used, packed RBCs can be stored up to 42 days at room temperature
- PRP is further processed through centrifugation using a heavy spin to separately produce a platelet concentrate and a platelet poor plasma.
- F (light spin)
- T
- T
- F (1-6C or ref temp)
- T
T or F
- If PPP is to be processed as FFP, freeze the plasma solid within 24 hours
- If PPP is to be processed as cryoprecipitate, remove the FFP from the freezer and thaw the plasma at room temperature to form the precipitate
- Once the plasma is slushy, it is placed back to the centrifuge at 4C thus resulting to a cryoprecipitate
- The cryoprecipitate settles at the bottom of the bag
- Excess plasma / cryo-poor plasma is stored at 1-6C
- F (within 8 hours)
- F (at 1-6C or ref temp)
- T
- T
- F (-18C)
Whole blood
Identify the following:
1. Storage
2. Volume
3. HCT
4. Selection of unit
- 1-6C or ref temp
- 450-500mL
- 40%
- ABO identical / type specific
What are the two benefits of whole blood
- has O2 carrying capacity –> improved oxygenation
- Volume expander (unit has plasma)
What are the uses of whole blood?
- limited, rarely has uses
- autologous transfusion
- massive transfusion / correct hypovolemia
What is the increased increment after 48-72 hours since transfusion
3% Hct
1 g/dL Hgb
whole blood contains which components if less than 8 hours or after 24 hours, stored at 22C
- red cells
- platelets
- buffy coat
- fresh frozen plasma
What does whole blood contain after storage at 4C for 24 to 72 hours
only red cells remain
kasi within 8 hours lang yung FFP and PLT
pREPARATION OF WHOLE BLOOD COMPONENT
- optimum setting of the cryofuge
- Centrifuge must be spin unloaded until it reaches ____
- Once equal weight is achieved, the whole blood is loaded into onto the ____
- Whole blood is placed toward the (inside / outside) of the circular centrifuge bucket
- Ensure that the attached bags and segments are ____ into the bucket next to the unit.
- 18-22C (room tem)
- optimum temperature
- centrifuge bucket
- outside
- securely folded
- ____ the segments and bags properly will prevent them from becoming loose and attaching to other buckets, or being cut during centrifugation
- Check if the buckets are ____ freely on their axis, sometimes, ____ is applied to the buckets
- What happens is the buckets are not swinging?
- what temp is needed to prevent PLT aggregation?
- folding
- swinging , grease
- RBCs will not settle properly
- 20-24C
a. light spin
b. heavy spin
- used to keep the platelets suspended in the plasma
- platelets will settle into the buffy coat
- there will be no platelet concentrate available for harvesting
- a
- b
- b
- after centrifugation, carefully examine the unit to confirm that the plasma is ____
- The buckets are carefully removed from the centrifuge and placed in a ____
- clear
- plasma expressor
approximately ____ of donor plasma is expressed through a filter into the first satellite bag to produce platelet-rich plasma (PRP)
200-250 mL
The RBC unit and additive pack are separated from the
____ and sent for preparation of AS-3 RBC LR. (AS=
additive solution)
Platelet rich plasma (PRP)
If a blood collection set up doesn’t have an additive, where do you cut?
after the mother bag
What are the two seals that may be used after processing packed RBC
- electric sealer
- aluminum clip / buhol-buhol system resulting to a white knot
Separation of PRP
- Serparation of PRP will be further processed into what products?
- PRP is centrifuged at what temperature?
- PRP is centrifuged using (light / hard) spin
- Platelet concentrate will be found at the (top / bottom) of the satellite bag
- platelet concentrate and plasma
- room temperature
- hard spin
- bottom of the satellite bag
Separation of PRP
T or F
1. what would remain in the primary satellite bag would be RBCs suspended in 50-70mL of plasma
2. PPP will now be stored as fresh frozen plasma (FFP)
- F (PLT concentrate will be suspended in plasma)
- T
RBCs
- storage for RBCs?
- When is it prepared?
- Hematocrit?
- Final red cell volume?
- Selection of unit?
- 1-6C
- shortly after collection or anytime during storage
- 70-80% (CPDA-1) or 55-65% (with AS)
- 160 to 275 ml or 50 to 80 g of hemoglobin
- ABO identical or type specific
