RBC Products Flashcards
Exam 3
In what situation would whole blood be transfused to a patient?
When it is needed to replace both RBC mass and plasma volume
What hemoglobin level indicates that transfusion of red cells may be necessary?
<7 g/dL
By how much will one unit of red cells increase the hemoglobin and hematocrit?
Hgb will increase 1 g/dL and hematocrit 3%
List the clinical indications for a red cell transfusion.
Patients who need increased oxygen carrying capacity, surgery/traumatic bleeding, anemia of various causes, cancer/leukemia (chemotherapy can destroy blood components)
What symptoms may a patient have that indicates they may need a red cell transfusion?
Pulse > 100 bpm, respiration > 30 breaths per minute, dizziness, weakness, chest pain
How much plasma is removed from a whole blood unit to make a CPDA-1 unit? AS unit?
CPDA-1 remove 200-250 mL plasma, AS remove 300 mL plasma
What are some reasons a red cell would be frozen?
Rare blood units, autologous units (usually for rare antibody cases), units for a special purpose (such as intrauterine transfusion)
What chemical must be added to the red cell upon freezing?
Glycerol
What is the function of citrate in an anticoagulant solution?
Chelates calcium and prevents clotting
What is the function of monobasic sodium phosphate in an anticoagulant solution?
Maintains pH during storage, necessary for maintenance of adequate levels of 2,3-DPG
What is the function of adenine in an anticoagulant solution?
Aid in the production of ATP
What is the function of dextrose in an anticoagulant solution?
Substrate (glucose) for ATP production
What is RBC rejuvenation?
Process used to restore ATP and 2,3-DPG levels with metabolic alterations.
What components are present in a rejuvenation solution?
Phosphate, inosine, pyruvate, adenine
Rejuvenating a red cell will increase the outdate on a red cell how many days?
3 days
An individual who is type A can receive what types of red cells?
A and O
An individual who is type AB can receive what types of red cells?
Any of them
What is a red cell exchange transfusion?
This removes the patient’s RBCs and re-transfuses the patient’s plasma and platelets along with donor allogeneic RBCs
What patient population commonly receives red cell exchange transfusions?
Sickle cell patients, sometimes malaria and babesia infected patients, removing incompatible RBCs
What happens to the % of viable cells in a red cell unit as it is stored over time?
It decreases
What happens to the glucose levels in a red cell unit as it is stored over time?
It decreases
What happens to the ATP levels in a red cell unit as it is stored over time?
It decreases
What happens to the lactic acid levels in a red cell unit as it is stored over time?
It increases
What happens to the pH levels in a red cell unit as it is stored over time?
It decreases
What happens to the 2,3-DPG levels in a red cell unit as it is stored over time?
It decreases
What happens to the plasma potassium levels in a red cell unit as it is stored over time?
It increases
What happens to the plasma hemoglobin levels in a red cell unit as it is stored over time?
It increases
What happens to the oxygen disassociation curve in a red cell unit as it is stored over time?
It shifts to the left due to an increase in oxygen affinity
Why must whole blood transfusions be ABO identical?
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.
How does intraoperative blood salvage work?
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.
