T8 - L3 Blood transfusion Flashcards
which components of blood are available for transfusion?
red blood cells
platelets
plasma
what is the time limit once blood is removed from the fridge?
4 h limit from removal from cold storage to end of transfusion
when do we do a transfusion of RBC?
- significant bleeding
- acute anaemia
- chronic anaemia
how are platelets collected?
pooled platelets:
1 unit of platelet is produced from a unit of whole blood.
4-6 of these units (from different donors) are pooled together in a single pack
aphesis platelets: As blood cycles through apheresis machine, platelets are removed
platelets are stored at what temperature?
“room temperature” 22 degrees
shelf-life = five days from collection
why would we transfuse platelets?
- Treatment of bleeding due to severe thrombocytopenia (low platelets) or platelet dysfunction
- Prevention of bleeding in patients with thrombocytopenia or platelet dysfunction
what are contraindications of platelet transfusions?
- Immune thrombocytopenic purpura
- Thrombotic thrombocytopenic purpura
- Heparin induced thrombocytopenia & thrombosis
what temperature is fresh frozen plasma stored at?
-30 degrees
why transfuse fresh frozen plasma?
- to treat significant bleeding in patients with abnormal clotting results
- to correct abnormal clotting results prior to invasive procedures
when do you NOT transfuse FFP?
- To treat single factor deficiencies
- To correct abnormal clotting results in patients that are not bleeding
- To reverse warfarin
what do you use for the reversal of warfarin anticoagulation?
Prothrombin complex concentrate (factor IX complex)
what is Cryoprecipitate?
- component of plasma
- Cryoprecipitate is extracted from FFP, during the thawing process.
- Contains fibrinogen, von Willebrand, factor VIII, factor XIII
- Therapeutic dose :10-15 ml/kg (6-10 units)
- It is mainly used as a concentrated source of fibrinogen in acquired coagulopathies
what are non-immunological complications of transfusion?
- transmitted infection
- TACO (transfusion associated circulatory overload)
- Febrile non-haemolytic transfusion reaction (FNHTR)
- Haemochromatosis
what are immunological complications of transfusion?
- Acute haemolytic transfusion reaction due to incompatibility
- Delayed haemolytic reaction
- Post transfusion purpura
- Allergic /anaphylactic reaction
- TRALI (Transfusion-related acute lung injury)
- Transfusion-associated graft-versus-host disease (TA-GvHD)
what are signs and symptoms of a blood Transfusion of Bacterial contaminated components?
- Rigors
- High fever
- Severe chills
- Hypotension
- Nausea
- Vomiting
- dyspnoea
- Circulatory collapse
within first 15 minutes
what is Transfusion associated circulatory overload (TACO)?
common transfusion reaction in which pulmonary edema develops primarily due to volume excess or circulatory overload
what is the onset for TACO?
up to 24 hours after transfusion
signs and symptoms fo TACO?
- sudden dyspnoea
- orthopnoea
- tachycardia
- hypertension
- hypoxemia.
signs:
- raised BP
- evaluated JVP
risk factors for TACO?
- elderly patients
- small children
- patients with compromised
left ventricular function - large transfusion volume
- increased rate of transfusion
what is the reaction called when a blood transfusion patient is not compatible with the blood being transfused?
Acute haemolytic reaction
what is “cross matching” for RBC transfusions?
Crossmatching” : Patient’s plasma is mixed with aliquots of donor red cells to see if a reaction (agglutination or haemolysis) occurs
