intro to blood banking and blood products Flashcards
plasma contents
coagulation factors, albumin, antibodies
indications for use of fresh frozen plasma
multiple coagulation deficiencies due to liver failure, diseminated intravascular coagulopathy (DIC), vitamin k deficiency, warfarin toxicity, or massive blood loss
indications for use of platelet concentrates
thrombocytopenia (<10,000 if asymptomatic) this may be caused by decreased platelet production or increased destruction (DIC)
indications for use of RBCs
increase in oxygen carrying capacity. hemodynamically unstable. transfusion criteria is usually hgb of <7
indication for use of albumin
bring osmotic pressure of intra and extra vascular back to normal in situation of hypovolemia and hypoproteinemia
type o patients
no abo rbc surface antigen. naturally occurring anti-a and anti-b antibodies
type a patients
type a rbc surface antigens. naturally occurring anti-b antibodies
type b patients
type b rbc surface antigen. naturally occurring anti-a antibodies
type ab patients
type ab rbc surface antigens. no naturally occurring anti-a or anti-b antibodies
basic Rh (D) blood group concept
Rh or D antigen is present at birth. However, unlike ABO antibodies, Anti-D antibodies are not present at birth
imunologically challenge related to rh blood group
if a patient is rh negative and is given rh positive blood. the patient will develop anti D antibody. Subsequent transfusion with Rh positive blood can be a problem.
universal donor for RBC
o negative
universal donor for FFP
AB
hemolytic transfusion reaction
most likely caused by ABO incompatibility. Rare but most severe. usually human error
clinical presentations for hemolytic transfusion reactions
DIC, acute renal failure, acute tubular necrosis, shock. the triads of fever, flank pain and red/brown urine occasionally occur
treatment of hemolytic transfusion reactions
this is a medical emergency. stop transfusion immediately. maintain airway. start saline at 100-2– ml/hr. notify the blood bank immediately. obtain blood and urine samples. vasopressors (dopamine) might be indicated for hypotension patients
febrile nonhemolytic transfusion reactions
caused by interleukins and TNFalpha substance within the blood products.
febrile nonhemolytic transfusion reactions clincal presentation
fever, chills, rigors, mild dyspnea
febrile nonhemolytic transfusion reactions treatment
stop transfusion since the symptoms look like more serious events. tylenol and or benadryl and symptomatic treatment are usually effective
delayed hemolytic transfusion reactions
this reaction is caused by atypical antibody present in the recipients. Usually occur 2-10 days post transfusion
delayed hemolytic transfusion reactions clinical presentation
symptoms are much less severe than acute reactions. slight fever, falling hct, mild increase of unconjugated bilirubinand spherocytes in blood smears. usually this is discovered by the blood bank staffs in patients with new alloantibodies against rbcs
delayed hemolytic transfusion reactions treatment
no treatments are necessary. however, antigen negative blood products should be administered in subsequent rbcs transfusion
anaphylactic transfusion reactions
just like all other medications transfusion of blood products do post risks of developing anaphylactic reactions
anaphylactic transfusion reactions clinical presentations
shock, hypotension, angioedema, and respiratory distress
anaphylactic transfusion reactions treatment
stop transfusion immediately. epi IM. prep for possible epi drip. maintain airway. saline. vasopressors if necessary
urticarial transfusion reactions
substance in blood products causes histamine release from mast cells and basophils causing hives or urticaria
urticarial transfusion reactions clinical presentation
skin lesions with hives or urticaria
urticarial transfusion reactions treatment
usually it isn’t necessary to stop transfusion. benadryl po or iv can be given if severe. if no signs of other more severe symptoms and hives are waning, transfusion may be resumed
post transfusion purpura (PTP)
very rare. usually associated with sensitization to a foreign antigen from previous platelet containing trasfusion. most common antigen is HPA-1a
ptp clincal presentation
severe thrombocytopenia lasting days to weeks 5-10 days post transfusion
ptp treatment
high dose corticosteroids or exchange transfusion, but has side effects and takes >2 weeks to be affective. IVIG at high dose X 5days usually is effective and is able to see effect in about 4 days. patients should receive washed cells or HPA-1a negative vells in subsequent transfusions
transfusion related acute lung injury
rare acutual cause is unclear. hypotheses: caused by anti-granulocytes antibodies initiating immune inflammatory response within pulmonary microvasculature.
transfusion related acute lung injury (TRALI) clinical presentation
sudden onset of respiratory distress during or after transfusion of blood products. fever, tachypnea, tachycardia, and hypotension can occur
