Heme - Blood components and transfusion reactions Flashcards
Whole blood:
3 cellular components?
Plasma derivatives?
Whole blood:
RBC, WBC, and platelets
Fresh frozen plasma, cryoprecipitate
Packed RBC:
- What are packed RBCs?
- Indications for packed RBCs?
- Why should transfusions be minimized?
Packed RBC:
- Packed RBCs have had plasma and platelets removed
- Indications: anemia, sickle cell, thallasemia
- Transfusions should be minimized to decrease Abs
Granulocytes (rarely given):
- Must be ____ compatible
- What are some complications?
- Indications?
Granulocytes:
- Must be ABO compatible
- Complications: rigor, allergy, CMV, or GVHD
- Indication: Severe sepsis
Platelets:
- Indications?
Single donor platelets:
- What is the benefit?
- ____ is matched
Platelets:
- Indication: count <10k, count <20k with bleeding, or for invasive procedures
Single donor platlets:
- Benefit of a single donor is decreased #Ags exposed to
- HLA is matched
Fresh frozen plasma:
- What does it contain?
- Indications?
Fresh frozen plasma:
- Contains all coagulation factors and plasma proteins
- Indications: coagulation factor deficiency, OD of coumadin, or coagulopathy (ex: liver disease)
Cryoprecipitate:
- What is it prepared from?
- What does it contain?
- Uses?
Cryoprecipitate:
- Prepared from fresh frozen plasma
- Contains factors 8 and 13, vWF, and fibrinogen
- Used mostly in critically ill patients, DIC, Hemophilia A, Afibrinogemia, and vWD
Transfusion reactions:
- Acute intravascular - primary Ab? Example?
- Acute extravascular - primary Ab? Example?
- Delayed intravascular - primary Ab?
- Delayed extravascular - primary Ab?
- Which type is the most dangerous?
Transfusion reactions:
- Acute intravascular - IgM: ABO
- Acute extravascular - IgG: Rh
- Delayed intravascular - IgG
- Delayed extravascular - IgG
- Most dangerous: acute intravascular
Hemolytic transfusion reactions:
- Most common cause is ___ incompatibility.
- Red cell destruction due to complement activation by __.
- Causes _____ failure
Hemolytic transfusion reactions:
- Most common cause is ABO incompatibility
- RBC destruction due to complement activation by IgM
- Causes multisystem failure
Hemolytic transfusion reactions:
- First response?
- What is done to prevent renal failure?
- How is HTR prevented?
Hemolytic transfusion reactions:
- STOP TRANSFUSION
- Infuse fluids and diuretics to increase urine output and maintain BP/perfusion to kidney
- Prevented by following procedures and compatability testing
Febrile nonhemolytic reactions:
- Cause from ____ on the ___ of the donor that react with the recipient ____.
- Symptoms? How to treat symptoms?
- What is a good preventative measure?
Febrile nonhemolytic reactions:
- Cause from HLA on the WBC of the donor that react with the recipient Abs.
- Fever, chills, shaking; tylenol and benadryl
- Give units with reduced leukocytes
Allergic transfusion reactions:
- Cause?
- Reaction?
- Prophylaxis?
Allergic transfusion reactions:
- Caused by Abs of the recipient to the proteins of the donor
- hives, itching, erythema, dyspnea
- Give antihistamine as prophylaxis
Anaphylactic Reactions:
- Associated with?
- Symptoms?
- NO ____
- Treat?
- Prevent?
Anaphylactic reactions:
- IgA antibodies in IgA deficient patients
- flushing, nausea, diarrhea, hypotension, arrhythmia, arrest, and laryngeal edema
- NO FEVER
- Epinepherine
- Give washed RBCs that have no IgA
Transfusion related lung injury:
- Caused by what 2 things?
- What occurs?
- Patient displays acute ____ insufficiency with x-ray showing?
Transfusion related lung injury:
- Donor Abs that react with recipient granulocytes or vice versa
- Lungs fill with a high-protein fluid
- Patient displays acute respiratory insufficiency with x-ray showing bilateral symmetric pulmonary edema
Transfusion related lung injury:
- Symptoms?
- Treatment?
- Prevention?
Transfusion related lung injury:
- dyspnea, cyanosis, tachycardia, and hypoxemia
- Treat with steroids
- Prevent: avoid donations from multiparous women and those who have reveived multiple transfusions (these people have more antibodies)
What are 2 acute non-immunologic reactions?
Bacterial contamination and circulatory overload