ISBB Finals Flashcards
Pretransfusion, Blood Components, Adverse Reactions
- Is diagnosed when dyspnea occurs within 24 hours post transfusion
- caused by increased intravascular volume due to excessive transfused fluid and/or too rapid of an infusion rate and the inability of the patient to accommodate the volume of transfused products due to impaired pulmonary, cardiac, or renal function.
Transfusion-Associated Dyspnea (TAD)
- a nonspecific sign that could be seen in a variety of other transfusion reactions or as part of the patient’s underlying condition
- when hypotension is seen alone during or within 1 hour after the transfusion is finished.
Adult: BP systolic drop of** ≥30 mm Hg** and systolic BP ≤80 mm Hg
Children: 25% drop in the baseline systolic BP
Hypotensive Transfusion Reaction
- Are one of the most common adverse TR
- Fever is greater than 100.4 F (38C)
- Or 1.8F (1.0C) from the pretransfusion level occurring during or **within 4 hours **after the end of the transfusion
- or** chills and/or rigors** are present
**Febrile Nonhemolytic Transfusion Reaction (FNHTR)
**
- The most common reactions seen with platelet and plasma transfusion
-* IgA deficiency* is defined as undetectable serum IgA (less than 0.5 mg/dL). Most IgA-related anaphylactic reactions occur in IgA-deficient persons with detectable class-specific anti-IgA antibodies. - However, reactions do not occur in the majority of patients, and anaphylaxis is rare.
Allergic Transfusion Reaction (ATRs)
- Headache is the most commonly reported symptom
- Fever, chills, nausea, vomiting, abdominal pain, diarrhea, facial flushing, urticaria, itching, muscular cramps, and back pain are other common symptoms
- albumin, intravenous immune globulin (IVIG), and human-derived factor concentrates, can be associated with adverse events other than viral transmission.
Adverse Reactions to Infusion of Plasma-Derived Products
- A clinical syndrome developing from 2 days to 6 weeks after transfusion characterized by the typical skin rash seen and other forms of GVHD, diarrhea, fever, enlarged liver, elevated liver enzymes, marrow aplasia, and/or pancytopenia.
- Definitive Diagnosis: skin biopsy (occasionally liver)
Transfusion-Associated Graft-vs- Host Disease
- is a rare transfusion reaction in which there is a severe and sudden drop in the platelet count, usually occurring 5 to 10 days after transfusion due to alloimmunization to platelet-specific antibodies from prior transfusion or pregnancy
- Diagnosis: Thrombocytopenia
Post-Transfusion Purpura
**Adverse Metabolic Effects of Transfusion
**
- excessive amounts of citrate can enter the circulation in massive transfusion or in patients with severe liver disease.
- can cause hypocalcemia and hypomagnesemia. In addition, metabolic alkalosis can de velop from bicarbonate produced from citrate metabolism.
Citrate toxicity
**Adverse Metabolic Effects of Transfusion
**
- During RBC storage, intracellular potassium slowly leaks from aging RBCs causing increased potassium in the super natant.
- is very uncommon in massive trans fusion in adults, but it is of special concern in neonatal transfusions, especially in premature infants.
- The signs and symptoms of increased potassium are due to neuromuscular and cardiac effects
Hyperkalemia
- causes:
Viruses, bacteria, non-infectious agents such as chemicals (drugs and alcohol), ionizing radiation, and autoimmune processes - As complication:
EBV, CMV, parvovirus, and HSV (these are not considered as hepatitis viruses)
Transfusion-Associated Hepatitis
- It is a single-stranded RNA lipid-enveloped virion that is common in Africa, West Asia, and the Middle East.
- The infection in humans has an incubation period of approximately 3 to 14 days following the mosquito bite, with symptoms lasting 3 to 6 days
West Nile Virus
WNV detection method
ELISA
- symptoms include fever, headache, rash, and muscle and joint pain.
- It is estimated that less than 20% of infected individuals experience symptoms.
- has been associated with severe neurological complications including increased rates of microcephaly and fetal brain anomalies during pregnancy and Guillain-Barre syndrome.
Zika Virus
Primary disease symptoms include high fever, severe joint pain, headache, muscle pain, rash, and leukopenia
Chikungunya Virus (CHIKV)
is the most common risk of infection due to transfusion of blood
Bacterial contamination
are the most common bacterial contaminants of blood
Staphylococcus epidermidis or S. aureus
According to the CDC, –––– is the most common isolate found in RBC units, followed by the Pseudomonas species.
Yersinia enterolitica
strongly indicates contamination. COLOR.
dark purple or black
clots in the unit and hemolysis may also indicate contamination.
Red Cells Shelf Life
a. ACD-A, CPD, CP2D: 21 days
CPDA-1: 35 days
a. ACD-A, CPD, CP2D: 35 days
CPDA-1: 21 days
a. ACD-A, CPD, CP2D: 21 days
CPDA-1: 35 days
a. ACD-A, CPD, CP2D: 35 days
CPDA-1: 21 days
Platelets shelf life
a. 24 hours
b. 1-6 days
c. 5 days
Platelets shelf life
a. 24 hours
b. 1-6 days
c. 5 days
The tubing that connects blood bags is usually made of
polyvinyl chloride (PVC)
Mechanical devices that apply pressure to the blood bag, which allows blood components to flow from one bag to another by way of the integrated tubing system
Plasma Expressors
