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I3 Exam 1 > Intro to Blood Components and Transfuion - Mo > Flashcards

Intro to Blood Components and Transfuion - Mo Flashcards

1
Q

What are the steps of blood component preparation

A

centrifuge and separate into red cells and platelet rich plasma

  • take PRP and push it into separate bag
  • hard spin which produces platelets that are separated out of the plasma
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2
Q

apheresis blood componenets

A
  • selective collection of individual components using specialized equipment
  • blood is separated by a centrifuge and unused components are returned to the donor
  • can get everything you need from one donor
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3
Q

What are the components of a red cell product

A

200 - 400 mL

  • 200 mL of RBC
  • 30 mL of plasma
  • 100 mL storage solution
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4
Q

What is RBC dosing for adults?

A

1 unit

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5
Q

What is RBC pediatric dosing?

A

5-15 mL/kG

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6
Q

What temperature should platelets be stored at?

A

room temperature

  • at higher risk for allowing bacterial growth
  • extremely limited resource because not that good for that long
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7
Q

What will 1 apherisis unit increase your platelet dose by?

A

30,000-60,000

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8
Q

What is the platelet count target for neurosurgery

A

80-100,000

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9
Q

What percent of blood is plasma?

A

55%

45% hematocrit

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10
Q

What is plasma used for?

A

correct coagulopathy

  • liver disease
  • DIC
  • warfarin reversal - replace vitamin K
  • massive transfusion
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11
Q

What should you be given if you need to replace a specific factor?

A

give factor concentrate

- don’t need to give plasma

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12
Q

What are the indications for plasma

A

documented factor deficiency and active bleeding or about to have a procedure

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13
Q

What is the best way to store plasma?

A

can be frozen

- but will expire quickly after defrosting

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14
Q

What is the adult dosing for plasma

A

10-20 mL/kG to increase factor level by 20%

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15
Q

What are the components of cryoprecipitate

A
  • factor VIII, XIII, vWF, fibrinogen

- small volume - need to pool 6-10 units from diff adults to make one adult dose

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16
Q

what are the indications for cryoprecipitate

A

hypofibrinogemia, DIC, obstetrical bleeding, massive transfusion

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17
Q

How is cryoprecipitate stored

A

frozen

- need to use right away after defrosting

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18
Q

What temp are RBC stored at

A

fridge

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19
Q

What is the usual dose of RBC

A

1 unit

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20
Q

What temp are platelets stored at

A

room temp

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21
Q

What is the usual dose of platelets

A

1 apheresis

- 1-6 WBP pool

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22
Q

What temp is plasma stored at

A

frozen

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23
Q

What is the usual dose of plasma

A

1-4 units

24
Q

What temp is cryoprecipitate stored at

A

frozen

25
Q

What is the usual dose of cryoprecipitate

A

6-10 units in a pool

26
Q

leukoreduction

A
  • filtration to remove WBC because they can contain infections
27
Q

irradiation

A

gamma or xray irradiation of cellular blood products

- prevent transfusion associated graft vs host disease in immunosuppressed patients

28
Q

washing

A

removal of plasma from cellular blood products

  • prevent hyperkalemia in pediatric patients
  • recurrent allergic reactions or igA deficiency
  • removal of incompatible antibodies
29
Q

volume reduction

A
  • centrifuge and removal of plasma
  • get rid of extra volume
  • prevent volume overload
  • remove incompatible antibodies
30
Q

What antibodies do you have in your plasma if you’re type A blood

A

anti-B antibody plasma

31
Q

What antibodies do you have in your plasma if you’re type B blood

A

anti-A antibody plasma

32
Q

What antibodies do you have in your plasma if you’re type AB blood

A

neither antibody

33
Q

What antibodies do you have in your plasma if you’re type O blood

A

you don’t have A or B antigen on your surface and you have both A and B antibodies

34
Q

How are the anti-ABO antibodies formed?

A

naturally occurring in the first 6 months of life

35
Q

Which group is the universal donor for RBC?

A

Group O - no antigens on the surface

36
Q

What type of red cells do group O people have to get?

A

Can only get O because they have both AB antibodies in their plasma

37
Q

Which group is the universal donor for plasma?

A

no antibodies in plasma

- AB

38
Q

What type of plasma can AB people get?

A

only from an AB person

39
Q

Which type of blood is the universal recipient

A

AB

40
Q

What can happen to Women that are Rh- and have an Rh+ fetus

A

can develop hemolytic disease of the newborn

  • first time women are exposed to the Rh they form antibodies
  • next time they are exposed the antibodies will bind and cause hemolysis
41
Q

D+ fetus inside of a D- mother

A
  • she forms antibodies
  • fetal maternal hemmorhage
  • certain antibodies across the placenta can cause fetal death
  • hemolytic disease of newborn
42
Q

How can you avoid hemolytic disease of the newborn

A

Rhogam pre and post birth

- anti-D antibodies

43
Q

What is the most severe type of transfusion rxn

A

transfusion related acute lung injury and TACO (cardiac)

  • very severe
  • ventilator
44
Q

leukoreduction

A

decreased WBC to improve safety profile

45
Q

CMV infection

A
  • stays in WBC for life
  • infection can be asymptomatic to tissue invasive
  • most donors have CMV
46
Q

how can you deal with CMV post-transfusion

A
  • remove WBC to remove CMV = CMV safe
  • test some donors - to see if they have CMV and leukoreduction
  • leukoreduction and CMV negative have a similar safety profile
47
Q

What are the most common transfusion rxns

A

allergic and febrile non-hemolytic

48
Q

What are the most serious transfusion rxns

A

TRALI: acute lung injury due to neutrophil activation by donor antibodies

  • TACO: cardiac overload due to rapid transfusions
  • sepsis due to bacterial overgrowth
49
Q

What do you do for a septic rxn?

A

stop the transfusion

  • keep the IV line open
  • clerical check of product and patient
  • note type od product
  • notify and send patient tube and product to blood bank
50
Q

What are the signs and symptoms that need to be monitored for a transfusion rxn

A

vital signs, supportive treatment, anti-pyretics, anti-histamines, anti-inflammatories, send pertinent labs to assess hemolysis and bacterial contamination

51
Q

lower severity allergic rxn

A
  • donor proteins cause histamine release in patient
  • flushing, urticaria
  • treat with anti-histamines
  • ok to re-start transfusion at slower rate if symptoms are mild
52
Q

higher severity allergic rxn

A
  • hypotension, airway edema, larger rash
  • emergent care
  • anti-histamines, vasopressors, corticosteroids
  • can consider volume reducing platelets to reduce plasma exposure
53
Q

Which part of the transfusion leads to the allergic rxn that patients experience

A

plasma is where the proteins are found

54
Q

What causes a febrile non-hemolytic transfusion rxn

A

donor WBC that secrete cytokines

  • febrile
  • chills
  • N/V
55
Q

What is the treatment for a febrile non-hemolytic transfusion rxn

A
  • discontinue transfusions

- if no hemolysis, can give another transfusion

56
Q

GVHD

A

graft vs host disease

  • due to donor lymphocytes start proliferating within the host
  • attack everything = everything is foreign

I3 Exam 1 (12 decks)

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