red cell components Flashcards
describe whole blood component
- volume
- storage temp
- shelf life
- avg hematocrit
- 450-500 mL
- 2-6C
- ACD/CPD 21 days
- 38%
for what purpose is whole blood transfusion used in
volume expansion and oxygen-carrying capactiy
- emergency release scenarios
- type O blood with low anti-A and anti-B titer
- symptomatic anemia with low volume
name considerations for whole blood transfusion storage
- PLT, WBC and clotting factors degrade in storage
what is the biggest risk for whole blood transfusions
- circulatory overload: too much blood for the heart to pump
- MUST match forward and reverse type
how does the FDA classify manufacturing
anything that changes the purity and potency of the product
-> not all blood banks are manufacturers, but all report to the FDA
list the steps for preparation of whole blood donations
1) collect in a sterile system (bacterial contam)
2) decide: what product is used for - changes procedures for the rest
3) centrifuge: pack and leukoreduced
4) separate components
5) test donor blood for type and viruses
6) label with ISBT
7) distribute
describe how decided to separate platelets alters whole blood preparation
- donation cool to room temperature (20-24C) within 24 hours
describe how deciding to separate plasma alters whole blood preparation
- donation cooled to 1-10 C within 8 hours
name the two different requirments for apheresis donors compared to normal donors
- 40% hct
- 16 week deferral
in what situations may apheresis be used as a clinical treatment
- plasmapheresis: warm auto-ab
- photopheresis: leukemia
- erythrocytapheresis: sickle cell
describe the differences in collection in apheresis: intermittent and continuous
- intermittent: blood out, pause, centrifuge etc
- continuous: blood is centrifuged as exiting
list risks associated with apheresis
- citrate toxicity: short term anti-coagulant given to donor
- vascular access
- vasovagal reactions
list requirements for leukocyte reduced packed RBCs (LRBC/PRBC)
- WBC count
- volume
- hct
- shelf life
- storage
- WBC: <5*10^6
- vol: 250-300mL
- hct: ~60-85% but best <80%
- shelf life: 21-42 days
- storage: store in 2-6C
when is LRBC given
- most common rbc component
- reduced HLA exposure and fever
- need CMV neg blood (leukocyte reduced)
- febrile TRXN
what is the expected outcome from LRBC transfusion
- hgb increase 1g/dL or hct 3% in 24 hours
list requirements of previously frozen deglycerolized rbc (DRBC):
- vol
- storage
- shelf life
- hct
- vol: 180mL
- storage: frozen -65C
- shelf life: 10 yrs -> once washed: 24 hrs
- hct: 70-80%
when are DRBC used
- rare antigens
- pt with allergies (the thawing step includes wash -> nothing in plasma to give allergies)
how do glycerol titrations allow red cell freezing
- titrations of glycerol maintain osmotic fragility of red cells during freezing process
list stats of leukocyte reduced irradiated packed rec cells (LIRBC):
- vol
- storage
- shelf life
- hct
- vol: 300 mL
- storage: 2-6C
- shelf life: 28 days post radiation or expiration date (whichever first)
- hct: <80%
when is LIRBC used
immunocompromised patients
what is the process of making LIRBC and maintaining
- RBCs leukoreduced and irradiated with 25-Gy of cesium or cobalt
- removes the ability of WBC to multiply
- radio chrome sticker indicates irradiation effective
-> cells have higher degradation rates post
what are the two main temperatures blood products are kept at
- 2-6C for storage (minimize bacterial contamination risk)
- 1-10C for transfer between sites/outside hospital
how does temperature impact expiration data
- unrefrigerated: 4 hrs
- refrigerated: 24 hrs
visual inspection: hemolysis
- description
- cause
- red halo at the top of the unit or in segments
- cause: extreme temp, centrifugation, manufacturing force, bacterial contam, incompatible solutions in product
visual inspection: lipemia
- description
- cause
- creamy plasma
- increaed triglycerides: fatty meal, chronic conditions
-> not tested for before distribution
visual inspection: bacterial contamination
- description
- cause
- darker than expected, bubbles, clots, hemolysis
- normal flora from collection process, loss of sterility during collection, asymptomatic bacteremia
visual inspection: particulate matter
- description
- next steps
- particulate matter:extra pieces from the collection, fibrin strands etc
- if persists after gentle agitation, or blocks tubing, should not be transfused
visual inspection: discoloration
- variation of plasma color
- orange to green is normal
- red = bad
- the darker the blood appears, the less oxygen there is
describe hemoglobin based oxygen carriers (HBOC)
- method of action
- use
- cons
- cell free hemoglobin
- used for traumas and sickle cell anemia
- vasoconstriction, renail failure, MI
describe universal red cell engineering
- method of action
- use
- cons
- gut bacteria remove or sequester A or B or H sugars
- creation of universal donor from any blood
- dependent on volume blood donors, extra steps, possible sepsis
