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Y3R4 - BMS 🏥 > L8: Blood Components Transfusion > Flashcards

L8: Blood Components Transfusion Flashcards

1
Q

what are blood components?

A
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2
Q

Content of Packed RBCs

A
  • RBCs.
  • A preservative, typically citrate-based.
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3
Q

Indications of Packed RBCs

A
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4
Q

RBC transfusion is not routinely indicated for pharmacologically treatable anemia as …..

A
  • Iron deficiency anemia.
  • Vitamin B12 or folate deficiency anemia.
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5
Q

Preparation of Packed RBCs

A
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6
Q

Adminstration of Packed RBCs

A
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7
Q

RBC Transfusion Recommendations for Hospitalized, Hemodynamically stable patients in specific clinical Situations

A
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8
Q

Rate of Production of Platlet Concentration

A

2-5 x 10^6 / sec in adults.

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9
Q

Normal range of Platlet Concentration

A
  • 150-400 x 10^9/L.
  • 150-400 x 10^6/cm3
  • 150-400 x 10^3/mm3
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9
Q

Antigens of Platlet Concentration

A
  • Strong expression of HLA class-I antigens.
  • Weak expression of ABO antigens.
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9
Q

Types of platlet concentrate

A
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10
Q

when are HLA-matched platelets Used?

A

Used in refractory patients who don’t have satisfactory respor a normal platelet transfusion.

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11
Q

what is Platelet refractoriness?

A

The repeated failure to obtain satisfactory response to platelet transfusion.

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12
Q

Temperature of Platlet Storage

A

between 20°C & 24°C

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12
Q

Storing of Platlet Storage

A

A platelet agitator…

  • Ensure viability & prevent aggregation.
  • By providing continuous gentle horizontal motion to the packs.
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13
Q

Causes of Platelet refractoriness

A
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14
Q

Shelf life of Platlet Storage

A

5 - 7 days.

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15
Q

If any gross aggregates are seen do not transfuse.

A

if any gross aggregates are seen do not transfuse.

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16
Q

Adminstation of Platlet Concentration

A
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17
Q

Indications of Platlet Concentration

A
  • TTT
  • Prophylaxis
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18
Q

Indications of Platlet Concentration as a TTT

A

Aim: A platelet count of >75 x 10’ /L

In multiple trauma & eye or CNS injury: keep platelet count >100 x 10°/L

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19
Q

Indications of Platlet Concentration as a prophylaxis

A

Platelel count Less than 10 x 10^9 /L

  • Platelet transfusion is not required routinely prior to bone marrow aspiration/biopsy, Prophylaxis in stable patients with long term bone marrow failure.

Plalelel count less tahn 20 x 10^9 / L & presence of Additional risk factors for bleeding as sepsis

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20
Q

Target platelet counts during surgery

A
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21
Q

Content of Fresh Frozen Plasma

A
  • Plasma, including all coagulation factors & plasma proteins.
  • All cellular components are removed from the transfusion product.
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22
Q

Indications of Fresh Frozen Plasma

A
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23
Q

Adminstation of Fresh Frozen Plasma

A
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24
Q

Thawed plasma should be given within max 2 hours to avoid loss of potency of coagulation factors.

A

…

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25
Q

Def of Crypercepitate Transfusion

A

The small fraction of plasma that separates out (precipitates) when plasma is frozen & then thawed in the refrigerator.

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26
Q

Content of Crypercepitate Transfusion

A
  • Clotting factors (Fibrinogen - Factor VIII - Factor XIII), Concentrated smaller amount of Liquid.
  • VWF (von Willebrand Factor).
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26
Q

Def of Granulocyte Transfusion

A

A medical procedure in which granulocytes (as neutrophil) are infused into a person’s blood.

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27
Q

Indications of Crypercepitate Transfusion

A
  • Replace several blood ciotting factors such as:
    1. Factor VIII (Missing in patients with hemophilia A).
    2. Fibrinogen (less than 0.8 -1 g/l).
  • Replace Von Willebrand factor (needed to help platelets work).
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28
Q

Collection of Granulocyte Transfusion

A
  • Collected by apheresis.
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29
Q

Transfusion of Granulocyte Transfusion

A

Granulocyte must be transfused as soon as possible after collection, As their function deteriorates rapidly with storage.

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30
Q

Indications of Granulocyte Transfusion

A
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31
Q

Criteria of Donor Selection in Blood Transfusion

A
  • Wellbeing
  • Age
  • Whole blood volume collected & weight of donor
  • Donation Interval
  • BP
  • Pulse
  • Temperature
  • Respiration
  • Hemoglobin
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32
Q

Wellbeing

Criteria of Donor Selection in Blood Transfusion

A

The donor shall be:

  • In Good health - Mentally alert - Physically fit.
  • No findings suggestive of:
  • End organ damage or secondary.
  • Complication (cardiac, renal, eye or vascular).
  • History of feeling giddiness, fainting made out during history & examination.
33
Q

Age

Criteria of Donor Selection in Blood Transfusion

A
  • Minimum age: 18 years.
  • Maximum age: 65 years.
34
Q

Whole blood volume collected & Weight of donor

Criteria of Donor Selection in Blood Transfusion

A

350 ml → 45 kg.
450 ml → 55 or more kg.

34
Q

BP

Criteria of Donor Selection in Blood Transfusion

A

Systolic 100-140 mmHg
Diastolic 60-90 mmHg.

35
Q

Donation interval

Criteria of Donor Selection in Blood Transfusion

A

For whole blood donation:

  • For males: Once in 3 months
  • For females: Once in 4 months
36
Q

Pulse

Criteria of Donor Selection in Blood Transfusion

A
  • Rate: 60-100/min.
  • Rhythm: regular.
37
Q

Temperature

Criteria of Donor Selection in Blood Transfusion

38
Q

Respiration

Criteria of Donor Selection in Blood Transfusion

A

Free from respiratory diseases

39
Q

…

39
Q

Hemoglobin

Criteria of Donor Selection in Blood Transfusion

A

Moran than or equal 12.5 gm/dl

40
Q

Mind Map of adverse transfusion reactions

41
Q

Infectious adverse effects

42
Q

what are acute transfusion reactions?

A
  • Febrile Non-Hemolytic Transfusion Reaction
  • Allergic (urticarial) reactions
  • Anaphylactoid / anaphylactic
  • Acute hemolytic transfusion reaction (AHTR)
  • Transfusion related acute lung injury (TRALI)
43
Q

Frequency of Febrile Non-Hemolytic Transfusion Reaction

A

0.1 - 1.0 %

44
Q

Mechanism of Febrile Non-Hemolytic Transfusion Reaction

45
Q

Clinical features of Febrile Non-Hemolytic Transfusion Reaction

A

Increased Temperature more than or equal 1C (2°F) within 2 hours of start of transfusion with no other explanation for fever

46
Q

Managment of Febrile Non-Hemolytic Transfusion Reaction

A
  • Risk minimized with leukocyte-reduced products.
  • Acetaminophen premedication if reactions are recurrent.
47
Q

Frequency of Allergic (urticarial) reactions

48
Q

Mechanism of Allergic (urticarial) reactions

49
Q

Clinical features of Allergic (urticarial) reactions

A
  • Urticaria.
  • Flushing.
  • Pruritus.
  • Mild wheezing.
50
Q

Managment of Allergic (urticarial) reactions

A
  • Pause transfusion.
  • Administer antihistamines.
  • Resume transfusion if reaction resolves, but still
  • report reaction to blood bank.
51
Q

Frequency of Anaphylactoid / anaphylactic Reactions

A

1: 20,000 - 50,000

52
Q

Mechnism of Anaphylactoid / anaphylactic Reactions

53
Q

Clinical Features of Anaphylactoid / anaphylactic Reactions

A
  • Hypotension.
  • Bronchospasm.
  • Anx
  • Urticaria.
  • Angioedema.

Rule out hemolysis.

54
Q

Managment of Anaphylactoid / anaphylactic Reactions

A
  • Stop transfusion.
  • IV colloids: to maintain Blood pressur circulatory volume.
  • Antihistamines & corticosteroids.
  • In severe cases:
  • Administer epinephrine 1:1000 (0.2-0.
55
Q

Cause of Acute hemolytic transfusion reaction (AHTR)

A
  • Preformed antibodies to incompatible product (1: 76,000).
  • ABO incompatibility (1: 40,000).
  • Sometimes fatal (1: 1.8 x 105).
56
Q

Frequency of Acute hemolytic transfusion reaction (AHTR)

A
  • Preformed antibodies to incompatible product (1: 76,000).
  • ABO incompatibility (1: 40,000).
  • Sometimes fatal (1: 1.8 x 105).
57
Q

Clinical Features in Acute hemolytic transfusion reaction (AHTR)

A
  • Fever.
  • Renal failure.
  • Chills.
  • Back pain.
  • Hypotension.
  • DIC (Disseminated Intravascular Coagulation).
  • Hemoglobinuria.
58
Q

Managment of Acute hemolytic transfusion reaction (AHTR)

A
  • Keep IV open with normal saline.
  • Keep Urine output >1 mL/kg/hour.
  • Vasopressors. “If needed”
  • Treat DIC.
59
Q

Frequency of Transfusion related acute lung injury (TRALI)

A
  • 1: 10,000 “uncommon syndrome”
60
Q

Cause of Transfusion related acute lung injury (TRALI)

61
Q

Mechanism of Transfusion related acute lung injury (TRALI)

62
Q

Clinical Features in Transfusion related acute lung injury (TRALI)

63
Q

managment of Transfusion related acute lung injury (TRALI)

A
  • No specific treatment exists for this syndrome, Management of TRALI is supportive.
  • Corticosteroids have been used for ALI/ARDS. “But the results are inconsistent”
  • For hypoxemia: Providing oxygen supplementation The central management approach”
64
Q

What are Delayed Transfusion Reactions?

A
  • Delayed HTR
  • Transfusion Associated Graft Versus Host Disease (TA GVHD)
65
Q

Mechanism of Delayed HTR

66
Q

Clinical Features of Delayed HTR

A

Include:
* Fever
* Jaundice.
* Falling hemoglobin.

67
Q

Managment of Delayed HTR

A

Transfuse PRN with compatible RBC.

PRN: Pro Re Nata means as needed

68
Q

Frequency of Transfusion Associated Graft Versus Host Disease (TA GVHD

69
Q

Mechanism of Transfusion Associated Graft Versus Host Disease (TA GVHD

A
  • Transfusion of viable T-cells presents in blood products.
  • This cells not rejected by the transfusion recipient because of:
    1. Recipient immunodeficiency.
    Or
    2. A common HLA haplotype between blood donor & recipien
70
Q

Risk Factors of Transfusion Associated Graft Versus Host Disease (TA GVHD

A
  • Volume & age of blood transfused, As this determine the number of viable T-cells.
  • HLA haplotype sharing between donor & recipient.
  • Depressed immune function.
71
Q

Time of Transfusion Associated Graft Versus Host Disease (TA GVHD

A

presenting 1-4 weeks after transfusion.

72
Q

CP of Transfusion Associated Graft Versus Host Disease (TA GVHD

A
  • Maculopapular rash.
  • Hepatitis.
  • Diarrhea.
  • Pancytopenia.
73
Q

Complications of Transfusion Associated Graft Versus Host Disease (TA GVHD

A

Almost always fatal with fatal outcome in mos patients.

74
Q

Managment of Transfusion Associated Graft Versus Host Disease (TA GVHD)

A

Prevented by irradiating blood products.

75
Q

Definition of Massive Blood Transfusion

A
  • Acute administration of > 1.5 times the patient estimated blood volume.
  • The replacement of the patient total blood volume by stored blood bank in less than 24
76
Q

Complications of Massive Blood Transfusion

A
  • Coagulopathy
  • Citrate toxicity
  • Hypothermia
  • Acid Base balance
  • Increased Serum potassium
77
Q

Incidence of Transfusion-Related Coagulopathy

A

Common with massive transfusion.

78
Q

Cause of Transfusion-Related Coagulopathy

79
Q

Transfusion-Related Citrate toxicity

80
Q

TTT of Transfusion-Related Citrate toxicity

A

Intravenous calcium administration.

But identification of the problem requires a high index of suspicion.

81
Q

Transfusion-Related Hypothermia

A
  • Should not occur on a regular basis.
  • Massive transfusion is an absolute indication for the warming of all blood & fluid to body temperature as it is being given.
82
Q

acid-base Balance in Massive Blood Transfusion

83
Q

Serum potassium in massive blood transfusion

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