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blood bank2 > red cell components > Flashcards

red cell components Flashcards

1
Q

describe whole blood component
- volume
- storage temp
- shelf life
- avg hematocrit

A
  • 450-500 mL
  • 2-6C
  • ACD/CPD 21 days
  • 38%
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2
Q

for what purpose is whole blood transfusion used in

A

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

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3
Q

name considerations for whole blood transfusion storage

A
  • PLT, WBC and clotting factors degrade in storage
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4
Q

what is the biggest risk for whole blood transfusions

A
  • circulatory overload: too much blood for the heart to pump
  • MUST match forward and reverse type
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5
Q

how does the FDA classify manufacturing

A

anything that changes the purity and potency of the product
-> not all blood banks are manufacturers, but all report to the FDA

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6
Q

list the steps for preparation of whole blood donations

A

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

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7
Q

describe how decided to separate platelets alters whole blood preparation

A
  • donation cool to room temperature (20-24C) within 24 hours
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8
Q

describe how deciding to separate plasma alters whole blood preparation

A
  • donation cooled to 1-10 C within 8 hours
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9
Q

name the two different requirments for apheresis donors compared to normal donors

A
  • 40% hct
  • 16 week deferral
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10
Q

in what situations may apheresis be used as a clinical treatment

A
  • plasmapheresis: warm auto-ab
  • photopheresis: leukemia
  • erythrocytapheresis: sickle cell
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11
Q

describe the differences in collection in apheresis: intermittent and continuous

A
  • intermittent: blood out, pause, centrifuge etc
  • continuous: blood is centrifuged as exiting
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12
Q

list risks associated with apheresis

A
  • citrate toxicity: short term anti-coagulant given to donor
  • vascular access
  • vasovagal reactions
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13
Q

list requirements for leukocyte reduced packed RBCs (LRBC/PRBC)
- WBC count
- volume
- hct
- shelf life
- storage

A
  • WBC: <5*10^6
  • vol: 250-300mL
  • hct: ~60-85% but best <80%
  • shelf life: 21-42 days
  • storage: store in 2-6C
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14
Q

when is LRBC given

A
  • most common rbc component
  • reduced HLA exposure and fever
  • need CMV neg blood (leukocyte reduced)
  • febrile TRXN
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15
Q

what is the expected outcome from LRBC transfusion

A
  • hgb increase 1g/dL or hct 3% in 24 hours
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16
Q

list requirements of previously frozen deglycerolized rbc (DRBC):
- vol
- storage
- shelf life
- hct

A
  • vol: 180mL
  • storage: frozen -65C
  • shelf life: 10 yrs -> once washed: 24 hrs
  • hct: 70-80%
17
Q

when are DRBC used

A
  • rare antigens
  • pt with allergies (the thawing step includes wash -> nothing in plasma to give allergies)
18
Q

how do glycerol titrations allow red cell freezing

A
  • titrations of glycerol maintain osmotic fragility of red cells during freezing process
19
Q

list stats of leukocyte reduced irradiated packed rec cells (LIRBC):
- vol
- storage
- shelf life
- hct

A
  • vol: 300 mL
  • storage: 2-6C
  • shelf life: 28 days post radiation or expiration date (whichever first)
  • hct: <80%
20
Q

when is LIRBC used

A

immunocompromised patients

21
Q

what is the process of making LIRBC and maintaining

A
  • 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
22
Q

what are the two main temperatures blood products are kept at

A
  • 2-6C for storage (minimize bacterial contamination risk)
  • 1-10C for transfer between sites/outside hospital
23
Q

how does temperature impact expiration data

A
  • unrefrigerated: 4 hrs
  • refrigerated: 24 hrs
24
Q

visual inspection: hemolysis
- description
- cause

A
  • red halo at the top of the unit or in segments
  • cause: extreme temp, centrifugation, manufacturing force, bacterial contam, incompatible solutions in product
25
Q

visual inspection: lipemia
- description
- cause

A
  • creamy plasma
  • increaed triglycerides: fatty meal, chronic conditions
    -> not tested for before distribution
26
Q

visual inspection: bacterial contamination
- description
- cause

A
  • darker than expected, bubbles, clots, hemolysis
  • normal flora from collection process, loss of sterility during collection, asymptomatic bacteremia
27
Q

visual inspection: particulate matter
- description
- next steps

A
  • particulate matter:extra pieces from the collection, fibrin strands etc
  • if persists after gentle agitation, or blocks tubing, should not be transfused
28
Q

visual inspection: discoloration
- variation of plasma color

A
  • orange to green is normal
  • red = bad
  • the darker the blood appears, the less oxygen there is
29
Q

describe hemoglobin based oxygen carriers (HBOC)
- method of action
- use
- cons

A
  • cell free hemoglobin
  • used for traumas and sickle cell anemia
  • vasoconstriction, renail failure, MI
30
Q

describe universal red cell engineering
- method of action
- use
- cons

A
  • 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

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