RBC Products

Question 1

In what situation would whole blood be transfused to a patient?

Answer 1

When it is needed to replace both RBC mass and plasma volume

Question 2

What hemoglobin level indicates that transfusion of red cells may be necessary?

Answer 2

<7 g/dL

Question 3

By how much will one unit of red cells increase the hemoglobin and hematocrit?

Answer 3

Hgb will increase 1 g/dL and hematocrit 3%

Question 4

List the clinical indications for a red cell transfusion.

Answer 4

Patients who need increased oxygen carrying capacity, surgery/traumatic bleeding, anemia of various causes, cancer/leukemia (chemotherapy can destroy blood components)

Question 5

What symptoms may a patient have that indicates they may need a red cell transfusion?

Answer 5

Pulse > 100 bpm, respiration > 30 breaths per minute, dizziness, weakness, chest pain

Question 6

How much plasma is removed from a whole blood unit to make a CPDA-1 unit? AS unit?

Answer 6

CPDA-1 remove 200-250 mL plasma, AS remove 300 mL plasma

Question 7

What are some reasons a red cell would be frozen?

Answer 7

Rare blood units, autologous units (usually for rare antibody cases), units for a special purpose (such as intrauterine transfusion)

Question 8

What chemical must be added to the red cell upon freezing?

Answer 8

Glycerol

Question 9

What is the function of citrate in an anticoagulant solution?

Answer 9

Chelates calcium and prevents clotting

Question 10

What is the function of monobasic sodium phosphate in an anticoagulant solution?

Answer 10

Maintains pH during storage, necessary for maintenance of adequate levels of 2,3-DPG

Question 11

What is the function of adenine in an anticoagulant solution?

Answer 11

Aid in the production of ATP

Question 12

What is the function of dextrose in an anticoagulant solution?

Answer 12

Substrate (glucose) for ATP production

Question 13

What is RBC rejuvenation?

Answer 13

Process used to restore ATP and 2,3-DPG levels with metabolic alterations.

Question 14

What components are present in a rejuvenation solution?

Answer 14

Phosphate, inosine, pyruvate, adenine

Question 15

Rejuvenating a red cell will increase the outdate on a red cell how many days?

Answer 15

3 days

Question 16

An individual who is type A can receive what types of red cells?

Answer 16

A and O

Question 17

An individual who is type AB can receive what types of red cells?

Answer 17

Any of them

Question 18

What is a red cell exchange transfusion?

Answer 18

This removes the patient’s RBCs and re-transfuses the patient’s plasma and platelets along with donor allogeneic RBCs

Question 19

What patient population commonly receives red cell exchange transfusions?

Answer 19

Sickle cell patients, sometimes malaria and babesia infected patients, removing incompatible RBCs

Question 20

What happens to the % of viable cells in a red cell unit as it is stored over time?

Answer 20

It decreases

Question 21

What happens to the glucose levels in a red cell unit as it is stored over time?

Answer 21

It decreases

Question 22

What happens to the ATP levels in a red cell unit as it is stored over time?

Answer 22

It decreases

Question 23

What happens to the lactic acid levels in a red cell unit as it is stored over time?

Answer 23

It increases

Question 24

What happens to the pH levels in a red cell unit as it is stored over time?

Answer 24

It decreases

Question 25

What happens to the 2,3-DPG levels in a red cell unit as it is stored over time?

Answer 25

It decreases

Question 26

What happens to the plasma potassium levels in a red cell unit as it is stored over time?

Answer 26

It increases

Question 27

What happens to the plasma hemoglobin levels in a red cell unit as it is stored over time?

Answer 27

It increases

Question 28

What happens to the oxygen disassociation curve in a red cell unit as it is stored over time?

Answer 28

It shifts to the left due to an increase in oxygen affinity

Question 29

Why must whole blood transfusions be ABO identical?

Answer 29

Whole blood contains both RBCs and plasma. Therefore the patient must be compatible with both those components. The only blood type that would be compatible with both the RBCs and plasma would be their own.

Question 30

How does intraoperative blood salvage work?

Answer 30

Autologous blood is collected during surgery from a surgical site, washed, mixed with anticoagulant and reinfused to the patient. This reduces the use of allogeneic blood products.