T8 - L3 Blood transfusion

Question 1

which components of blood are available for transfusion?

Answer 1

red blood cells

platelets

plasma

Question 2

what is the time limit once blood is removed from the fridge?

Answer 2

4 h limit from removal from cold storage to end of transfusion

Question 3

when do we do a transfusion of RBC?

Answer 3

• significant bleeding
• acute anaemia
• chronic anaemia

Question 4

how are platelets collected?

Answer 4

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

Question 5

platelets are stored at what temperature?

Answer 5

“room temperature” 22 degrees

shelf-life = five days from collection

Question 6

why would we transfuse platelets?

Answer 6

• Treatment of bleeding due to severe thrombocytopenia (low platelets) or platelet dysfunction
• Prevention of bleeding in patients with thrombocytopenia or platelet dysfunction

Question 7

what are contraindications of platelet transfusions?

Answer 7

• Immune thrombocytopenic purpura
• Thrombotic thrombocytopenic purpura
• Heparin induced thrombocytopenia & thrombosis

Question 8

what temperature is fresh frozen plasma stored at?

Answer 8

-30 degrees

Question 9

why transfuse fresh frozen plasma?

Answer 9

• to treat significant bleeding in patients with abnormal clotting results
• to correct abnormal clotting results prior to invasive procedures

Question 10

when do you NOT transfuse FFP?

Answer 10

• To treat single factor deficiencies
• To correct abnormal clotting results in patients that are not bleeding
• To reverse warfarin

Question 11

what do you use for the reversal of warfarin anticoagulation?

Answer 11

Prothrombin complex concentrate (factor IX complex)

Question 12

what is Cryoprecipitate?

Answer 12

• 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

Question 13

what are non-immunological complications of transfusion?

Answer 13

• transmitted infection
• TACO (transfusion associated circulatory overload)
• Febrile non-haemolytic transfusion reaction (FNHTR)
• Haemochromatosis

Question 14

what are immunological complications of transfusion?

Answer 14

• 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)

Question 15

what are signs and symptoms of a blood Transfusion of Bacterial contaminated components?

Answer 15

• Rigors
• High fever
• Severe chills
• Hypotension
• Nausea
• Vomiting
• dyspnoea
• Circulatory collapse

within first 15 minutes

Question 16

what is Transfusion associated circulatory overload (TACO)?

Answer 16

common transfusion reaction in which pulmonary edema develops primarily due to volume excess or circulatory overload

Question 17

what is the onset for TACO?

Answer 17

up to 24 hours after transfusion

Question 18

signs and symptoms fo TACO?

Answer 18

• sudden dyspnoea
• orthopnoea
• tachycardia
• hypertension
• hypoxemia.

signs:

• raised BP
• evaluated JVP

Question 19

risk factors for TACO?

Answer 19

• elderly patients
• small children
• patients with compromised
  left ventricular function
• large transfusion volume
• increased rate of transfusion

Question 20

what is the reaction called when a blood transfusion patient is not compatible with the blood being transfused?

Answer 20

Acute haemolytic reaction

Question 21

what is “cross matching” for RBC transfusions?

Answer 21

Crossmatching” : Patient’s plasma is mixed with aliquots of donor red cells to see if a reaction (agglutination or haemolysis) occurs