Plasma and its Fractions (Lect 3) Flashcards
Transfusion therapy
each blood component has specified indications for use and expected outcomes
blood is a “drug” and requires doctor order
Plasma dosage
assumed every mL of plasma will contain 1lu of coag factors, dosage is determined based on body weight
Cryoprecipitate dosage
utilized for what replacement in surgery/trauma
pt fibrinogen levels should be?
persons plasma vol?
what factors?
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)
FFP
hrs
contains max
used for pts with
fresh frozen plasma
8hr
contains maximum levels of clotting factors both stable and labile except one il/ml
Used for pts with factor deficiencies
Frozen plasma from whole blood collection
storage
thaw
store at -18c or colder for a year
thaw at 37c upon thaw, store at 1-6c
FP24
hrs
contains all
normal
slightly reduced
fresh plasma 24hr
contains all stable clotting factors, normal V, slightly reduced FVIII
To use frozen plasma from whole blood
thaw at and use within
“thawed plasma”
thaw at 30-37 c and used within 24hr
or 5 days for “thawed plasma”
“liquid plasma”
expires?
26 days?
used to do what during massive transfusions….until?
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
Cryoprecipitate preparation
how is it thawed?what temp?
what is resuspended? in what?
pooled in?
dosing in?
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
Cryoprecipitate contains
80 units of FVIII and 150mg fibrinogen
F13 and VWF
Storage/thaw of cryoprecipitate
frozen at
thaw at
store at?
must be used within … for pools?
for singles?
frozen at <-18c for 1yr
thaw at 37c
STORE AT RT until expiration, must be used within 4hr for pools
6 hrs for singles
Cryoreduced plasma preparation
Contains?
pp/a
left over from cryoprecipitate
Contains: plasma proteins/ADAMTS13 (def in cryo factors)
Storage/thaw of cryoreduced plasma
frozen at….
thaw and use like?
best for pts with?
frozen <-18c for 1yr
thaw and use like plasma
BEST FOR PTS W TTP
Plasma fractions
made from plasma collected from
what separations?
stored…for long?
issued by?
used for/
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
Activated FVII
used in?
or spon
used in massive bleeding, spontaneous thromboli
Factor VIII
used for what treatment
replaces?
safe from?
used for hemophilia A treatment, replaces cryoprecipitate
safe from HIV
Prothrombin complex
contains….dependent factors
utilized for
can cause..
contains vit K dependent factors (II,VIII,IX,X) utilized for massive bleeds
can cause DIC or thrombosis
FIX
utilized for?
contains FIX utilized for hemophilia B
Antithrombin III
used to prevent….
inhibits?
utilized to precent thromboembolism in surgical cases, inhibits factors IX,X,XI,XII
IG “IVIG” or “IMIG”
cons: IgA
concentrated IgG for immunocomp pts or to provide passive Ab prohpylaxis/thrombocytopenia
CONS: igA def may be at risk for allergic rxn
Rhogam
special IgG anti-D used to prevent HDFN associated with maternal Anti-D formation
normal serum albumin
what kind of pts?
hypov/hypopr
cons?
shock and burn pts/hypovolemic/hypoprotein
Cons: not good for dehydration
Convalasent plasma
must be?
used in emergencies under?
recently recovered from disease
must be ABO compatible
passive immunity
used in emergencies under FDA
ISBT labeling
changes on product/expiration dates
Visual inspection
if particulate matter is shaken and doesnt disspiate…
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
Pre transfusion testing
must be?
what happens every 72 hrs?
what doesnt matter?
what is not relevant/no?
plasma must be reverse types
blood type every 72 hr
RH DOESNT MATTER
AB screen not relevant/NO crossmatch
Best plasma for emergencies
AB plasma since it has no Abs
also A since most of the population is A or O
Infusion practice
must be ordered by
must confirm
infuses quicker than?
must be ordered by doctor
must confirm ID, blood type/visual
infuses quicker than rbcs (20-30min)
Monitoring of transfusion
coag: p/f/b/d/p
heme: p/h
bedside: v/r/t/a
Coag: PTT, Fibrino, BT, DDIMER, PT/INR
Hem: PLTS/HCT
Bedside: Visual, ROTEM/TEG/ACT
