Plasma and its Fractions (Lect 3)

Question 1

Transfusion therapy

Answer 1

each blood component has specified indications for use and expected outcomes

blood is a “drug” and requires doctor order

Question 2

Plasma dosage

Answer 2

assumed every mL of plasma will contain 1lu of coag factors, dosage is determined based on body weight

Question 3

Cryoprecipitate dosage
utilized for what replacement in surgery/trauma

pt fibrinogen levels should be?

persons plasma vol?

what factors?

Answer 3

Cryo is utilized for fibrinogen replacement in surgery/trauma.

Pt fibrinogen should be 100mg/dl

persons plasma vol est 30dl

(has factor 5 and 8)

Question 4

FFP
hrs
contains max

used for pts with

Answer 4

fresh frozen plasma

8hr

contains maximum levels of clotting factors both stable and labile except one il/ml

Used for pts with factor deficiencies

Question 5

Frozen plasma from whole blood collection

storage
thaw

Answer 5

store at -18c or colder for a year

thaw at 37c upon thaw, store at 1-6c

Question 6

FP24
hrs
contains all
normal
slightly reduced

Answer 6

fresh plasma 24hr

contains all stable clotting factors, normal V, slightly reduced FVIII

Question 7

To use frozen plasma from whole blood
thaw at and use within

“thawed plasma”

Answer 7

thaw at 30-37 c and used within 24hr
or 5 days for “thawed plasma”

Question 8

“liquid plasma”

expires?
26 days?
used to do what during massive transfusions….until?

Answer 8

never frozen, expires 5 days after whole blood, 26 days many coag factors are diminished

used to bridge gap during massive transfusion situations until FFP can be thawed

Question 9

Cryoprecipitate preparation
how is it thawed?what temp?

what is resuspended? in what?

pooled in?

dosing in?

Answer 9

FFP is thawed slowly at 1-6c liquid removed

solid components resuspended in 15ml plasma

often pooled in 5 donor units

dosing in factors of 10

Question 10

Cryoprecipitate contains

Answer 10

80 units of FVIII and 150mg fibrinogen
F13 and VWF

Question 11

Storage/thaw of cryoprecipitate
frozen at
thaw at

store at?
must be used within … for pools?
for singles?

Answer 11

frozen at <-18c for 1yr

thaw at 37c

STORE AT RT until expiration, must be used within 4hr for pools
6 hrs for singles

Question 12

Cryoreduced plasma preparation

Contains?
pp/a

Answer 12

left over from cryoprecipitate

Contains: plasma proteins/ADAMTS13 (def in cryo factors)

Question 13

Storage/thaw of cryoreduced plasma
frozen at….
thaw and use like?
best for pts with?

Answer 13

frozen <-18c for 1yr
thaw and use like plasma

BEST FOR PTS W TTP

Question 14

Plasma fractions
made from plasma collected from

what separations?
stored…for long?
issued by?
used for/

Answer 14

fractions made from plasma collected from whole blood/apheresis
pH/alc/Temp separation

stored lipopholized for long expiration, issued by pharmacy, used for factor deficiencies

Question 15

Activated FVII
used in?
or spon

Answer 15

used in massive bleeding, spontaneous thromboli

Question 16

Factor VIII
used for what treatment
replaces?
safe from?

Answer 16

used for hemophilia A treatment, replaces cryoprecipitate

safe from HIV

Question 17

Prothrombin complex
contains….dependent factors
utilized for

can cause..

Answer 17

contains vit K dependent factors (II,VIII,IX,X) utilized for massive bleeds

can cause DIC or thrombosis

Question 18

FIX
utilized for?

Answer 18

contains FIX utilized for hemophilia B

Question 19

Antithrombin III
used to prevent….
inhibits?

Answer 19

utilized to precent thromboembolism in surgical cases, inhibits factors IX,X,XI,XII

Question 20

IG “IVIG” or “IMIG”
cons: IgA

Answer 20

concentrated IgG for immunocomp pts or to provide passive Ab prohpylaxis/thrombocytopenia

CONS: igA def may be at risk for allergic rxn

Question 21

Rhogam

Answer 21

special IgG anti-D used to prevent HDFN associated with maternal Anti-D formation

Question 22

normal serum albumin
what kind of pts?
hypov/hypopr

cons?

Answer 22

shock and burn pts/hypovolemic/hypoprotein

Cons: not good for dehydration

Question 23

Convalasent plasma
must be?
used in emergencies under?

Answer 23

recently recovered from disease
must be ABO compatible
passive immunity

used in emergencies under FDA

Question 24

ISBT labeling

Answer 24

changes on product/expiration dates

Question 25

Visual inspection
if particulate matter is shaken and doesnt disspiate…

Answer 25

rbcs - pink
bacterial - bubbles

particulate matter: if shaken and doesnt dissipate, coag cascade has been activated

cryoprecipitate may have white clumps that may plug

birth control green

Question 26

Pre transfusion testing
must be?
what happens every 72 hrs?
what doesnt matter?
what is not relevant/no?

Answer 26

plasma must be reverse types

blood type every 72 hr

RH DOESNT MATTER

AB screen not relevant/NO crossmatch

Question 27

Best plasma for emergencies

Answer 27

AB plasma since it has no Abs

also A since most of the population is A or O

Question 28

Infusion practice
must be ordered by
must confirm

infuses quicker than?

Answer 28

must be ordered by doctor
must confirm ID, blood type/visual

infuses quicker than rbcs (20-30min)

Question 29

Monitoring of transfusion
coag: p/f/b/d/p
heme: p/h
bedside: v/r/t/a

Answer 29

Coag: PTT, Fibrino, BT, DDIMER, PT/INR

Hem: PLTS/HCT

Bedside: Visual, ROTEM/TEG/ACT