Fiser Chapter 3: Blood Products Flashcards
Which 2 blood products do not carry the risk of HIV and hepatitis? Why is this?
Albumin; serum globulins
They are heat treated
For what is donated blood screened?
HIV; HBV; HCV; HTLC; syphilis, West Nile Virus
These special populations benefit from CMV-negative blood.
- Low birthweight
- Bone marrow transplant
- Transplant patients
Universal blood donor
Type O
Should females of childbearing age receive Rh-positive or Rh-negative blood?
Rh Negative
Stored blood is high or low in 2,3 BPG. This causes a left or right shift in the Oxy-Hgb dissociation curve?
Low in 2,3-DPG; causes a left shift (increased affinity for oxygen)
Difference between type and screen and type and crossmatch
Type and screen: ABO compatibility and looks for pre-formed Ab’s to minor Ag
Type and cross: determines ABO compatibility
1U PRBC should raise Hgb by…
1
1 six-pack of platelets should raise platelet count by…
50,000
Issue with transfusing cold blood
Poor clotting can be caused by cold products or cold body temperature (coagulopathy 2/2 slowed enzyme reactions); patient should be warmed to clot correctly
T/F Dilutional thrombocytopenia and dilution of coagulation factors can occur with massive transfusion
True
What relative electrolyte deficiency is associated with massive transfusion? Why is this the case?
Hypocalcemia; poor clotting (required for clotting cascade); can also cause hypotension
- Citrate used in stored blood binds to Ca after transfusion and causes hypocalcemia
Most common bacterial contaminant of transfused blood.
GNR’s; usually E. coli
Most common blood product that is associated with contamination. Why is this?
Platelets because they are not refrigerated
What disease (aside from major infectious diseases) can be transmitted with blood transfusion?
Chagas’ disease
There are 3 possible hemolytic reactions to blood: acute, delayed, non-immune. Describe them.
Acute: ABOi (Type 2 hypersensitivity). Back pain, chills, tachycardia, fever, hemoglobunuria. ATN, DIC, shock. Haptoblogin < 50; increase in unconjugated bilirubin. Can present as diffuse bleeding in anesthetized patients
Delayed: mild jaundice; antibody-mediated against minor antigens from donor. Observation
Non-immunie: from squeezed blood; IVF and diuretics
Acute hemolytic reaction from ABOi blood transufsion is what type of hypersensitivity?
Type 2
Most common transfusion reaction and treatment.
Febrile non-hemolytic transfusion reaction; usually recipient Ab reaction against donor WBC’s (cytokines).
Treatment: discontinue transfusion; use WBC filters for subsequent transfusions
Can urticaria result from blood transfusion? How do you treat it?
Yes; recipients antibodies against donor plasma proteins (i.e. peanuts) or IgA in an IgA-deficient patient
Tx: Benadryl, supportive care
Can anaphylaxis result from blood transfusion?
Yes: bronchospasm, hypotension, angioedema, urticaria.
Recipient Ab vs. donor IgA in IgA deficient recipient
- Can be an airway emergency; Epi, IVF, pressors, steroids, benadryl
What is TRALI?
Transfusion-related ALI; caused by donor Ab to recipient WBC’s; clot in pulmonary capillaries
- Leads to non-cardiogenic pulmonary edema in < 6 hours and ARDS
- Most common cause of death from transfusion reaction
Most common cause of death from transfusion reaction
TRALI
Describe the type of transfusion reaction:
- Recipient Ab - donor WBC
- Recipient Ab - donor plasma proteins or donor IgA
- Recipient Ab- donor IgA
- Donor Ab- recipient WBC
- Febrile non-hemolytic transfusion reaction
- Urticaria
- Anaphylaxis
- TRALI
