THE WHOLE BLOOD AND ITS COMPONENTS Flashcards
1
Q
- Red cell concentrates
- Leukocyte-poor red blood cells
- Frozen-thawed red cells
A
Oxygen-carrying Products
2
Q
- Platelet-rich plasma (PRP)
- Platelet concentrates (PC)
A
Platelet Components
3
Q
- Fresh Frozen Plasma (FFP)
- Frozen Plasma (FP)
- Cryoprecipitate
- Stored plasma
A
Plasma Products
4
Q
- Normal Serum Albumin (NSA)
- Immune Serum Globulin (ISG)
- Factor VIII Concentrate
- Factor IX Concentrate
- Plasma Protein Fraction (PPF)
- Rhogam (Rh Ig)
A
Plasma Derivatives (From pooled plasma components)
5
Q
- primary component or MOTHER BAG, directly from the donor
- UNMODIFIED component
A
Whole Blood
6
Q
Indicated by Active bleeding, Hemorrhagic shock, Exchange transfusion
A
Whole Blood
7
Q
Whole blood is indicated when both ____ capacity and _____ are required
A
oxygen-carrying
volume expansion
8
Q
Shelf life of Acid Citrate Dextrose (ACD), Citrate Phosphate Dextrose (CPD), Citrate Phosphate Double-dose of Dextrose (CP2D) in Whole Blood
A
21 days
9
Q
Shelf life of CPD-A1 (Commonly used anticoagulant in blood bag) in Whole Blood
A
35 days
10
Q
Shelf life of CPD-AS-1, AS-3, AS-5 in Whole Blood
A
42 days
11
Q
Considerations in Whole blood
Temperature, transport requirement and characteristics of the other components especially if the storage of whole blood already lapsed after __
A
24 hours
12
Q
Characteristics of Whole Blood
WBC and platelet no longer viable after ____ storage
FV and FVIII decreases after ____ storage
A
24 hrs
2 days
13
Q
Storage temp of Whole Blood
A
1-6 degC
14
Q
Transport requirement for Whole blood
A
Wet ice
15
Q
Post Transfusion CBC of Whole blood
A
6 hours after transfusion
16
Q
Immediate effect of one unit:
Increase hematocrit by ____ each 1 unit of WB
A
3%
17
Q
Challenges Encountered After Whole Blood
Transfusion:
- ____ in patients requiring only O2-carrying capacity components
- Not indicated to correct ____ for normal volemic patients
A
Circulatory overload
anemia
18
Q
Component rich in HGB and RBC to increase the mass of the circulating red cell in situations where TISSUE OXYGENATION may be impaired
A
Packed RBC
19
Q
Indication of Packed RBC
A
Restore oxygen carrying capacity (anemia)
20
Q
Patients that commonly require RBC transfusion: (OEDCI)
A
- Oncology patients (undergo chemotherapy)
- End-stage renal disease patients
- Dialysis patients
- Chronic kidney disease
- Infants and neonates
21
Q
The QC of HCT in Packed RBC must be
A
80% or less
22
Q
Storage temp for Packed RBC
A
1-6 degC
23
Q
Open System, Once packed RBCs are prepared, it must be transfused within ____
Closed System, Should not be ___ for it to be considered as a closed system
A
24 hours
exposed to air
24
Q
In an Open system, it can be stored in the ___ depending on the anticoagulant used. Increased probability of ___ during collection
Closed systems are ____ attached needles that are connected to the satellite bags. It may contain _____ solution
A
refrigerator; contamination
integrally; anticoagulant
25
In an Open system, Red cell will settle down at the ____ of the bag when stored in the refrigerator
In a Closed system, Whole blood can be ___ from the bag to separate from plasma
bottom
centrifuged
26
The validity of the packed RBC in an open system will be ___ at ___
24 hours at 1-6°C
27
Immediate effect of one unit:
- Increase in ___ Hct
- Increase of ___ in Hgb
3%
1 g/dL
28
- Red blood cell component in which the WBCs have been REMOVED/REDUCED
- 85% remaining RBCs
- Most of WBCs are mostly DEPLETED
Leukodepleted RBC
29
Indicated by FNHTR, decrease alloimmunization to WBC or HLA antigens or CMV transfusion, should have the residual WBCs
Leukodepleted RBC
30
Shelf life of Leukodepleted RBC
Closed system –
Open System –
Closed system – same with Packed RBC (depends on the anticoagulant)
Open System – 24 hours
31
Storage temp of Leukodepleted RBC
1-6 degC
32
Means of Leukocyte Removal (CWM)
1. Centrifugation
2. Washing Procedures (using saline or glycerol)
3. Mechanical Separation (leukoreduced reduction filter)
33
Mechanical separation
Depends on the size of the filter
- 1st generation filter – ___ µm
- 2nd generation filter – ___ µm
- 3rd generation filter – ___
170
20-40
3-log filter
34
____ is recommended before storage, RBC its reduces leuko-reduced fragments and cytokines ____ in during storage
Pre-storage
increased
35
can be separated at the time of transfusion
Post-storage
36
added in RBC to restore the ATP and 2, 3 DPG that loses in storage
Rejuvenated RBC
37
Rejuvenation solution (PIGPA but PIPA now)
FDA approved solution = ___
phosphate, inosine, glucose (now removed), pyruvate and adenosine
Rejuvesol
38
Shel life of Rejuvenated RBC
- ____ prior for transfusion
- it can be prepared _____ after expiration of blood
24 hrs
3 days
39
Storage temp for Rejuvenated RBC
1-6 degC
40
- RBCs washed with STERILE SALINE for the REMOVAL of plasma proteins, platelets, leukocytes and cellular debris
- Only REDUCED and NOT completely remove leukocyte
Washed RBC
41
Indicated by Anemia with history of febrile reactions, PNH, IgA deficient patients
Washed RBC
42
Shelf life of Washed RBC
24 hours
43
QC requirement for Washed RBC
Plasma MUST be REMOVED
44
Storage temp for Washed RBC
1-6 degC
45
- Frozen RBCs are prepared for those with rare units such as AB (-) individuals, Bombay phenotype, Rh phenotype and patients that undergoes autologous donation
- Good for Anemic patients
- Freeze a particular component
Frozen > Thawed > Deglycerolized RBCs
46
Cryoprotective agent in Frozen > Thawed > Deglycerolized RBCs
Glycerol
47
Cryoprotective Agent: Glycerol
- High Concentration: ____ glycerol
Freezer requirement: Mechanical freezer = ___ (Preferred)
- Low Concentration: ____ glycerol
Requirement: Liquid Nitrogen (Prone formation of ice crystals that leads to cell lysis) = ____
- ___ Glycerol + Dextrose, Fructose and EDTA = ___
40%; - 65°C
20%; - 100°C
79%; -65°C
48
Shelf life of Frozen > Thawed > Deglycerolized RBCs
Frozen – ____
Deglycerolized – ____
10 years
24 hours
49
Storage temp of Frozen > Thawed > Deglycerolized RBCs
Freezing
50
Deglycerolize/ Thawed/ Defrost
Thaw - _____
Deglycerolized - ____
1-6 degC
wash the RBC via 3-step washing
51
Platelet Concentrates are done via
Random Donor Platelets
Single Donor Platelets
52
Prepared from whole blood
Indicated by thrombocytopenia, DIC, Platelet disorder/ bleeding
Random Donor Platelets
53
given to patient with impaired normal platelet function and impaired number of circulating platelet
Platelet component
54
Shelf life of Random donor platelet
5 days with constant agitation
55
Storage temp of Random donor platelet
20-24 degC
56
Contraindications of Random donor platelet (TH)
Triggers ITP
Heparin induced thrombocytopenia
57
QC of Random donor platelet
5.5 x 10^10 and 50-65mL of plasma sample
58
Immediate effect of Random donor platelet
Increase platelet count by____ per unit
5,000 – 10,000
59
Prepared from apheresis procedure
Indicated by Thrombocytopenia and for patients refractory to RDP due to platelet antibodies
Single donor platelet
60
Shelf life of Single donor platelet
Closed system –
Open system –
Closed system – 5 days
Open system – 24 hours
61
Storage temp of Single donor platelet
20-24 degC
62
Contents of Single donor platelet
____ platelets in approx.____ plasma
3.0 x 10^11
300 mL
63
Other platelet components that is for platelet transfusion for NEONATES (should have small volume; hence aliquoting) < 50,000 mL per unit
Pooled Aliquot
64
Other platelet components that is to PREVENT development of TAG-GVHD
Only difference with irradiated RBCs is that
RBCs shelf life is NOT altered/affected
Irradiated Platelets
65
Other platelet components that must be <8.3x10^5 of RESIDUAL WBCs for platelet-derived from whole blood -5x10^6 of residual WBC for apheresis
Leukoreduced Platelets
66
SDP is approximately 6 pooled RDPs is combined into 1 bag
It should be transfused within 4 hours of pooling
Pooled Platelets
67
- Plasma from whole blood donation can be manufactured into a variety of components: FROZEN or CRYOPRECIPITATE
- can be prepared by removing the plasma from a whole blood and frozen within 8 hours of collection
Fresh Frozen Plasma (FFP)
68
Indicated by replacement of plasma protein, treatment of multiple coagulation factor deficiencies, Massive Transfusion, Trauma, Liver Disease, DIC
Fresh Frozen Plasma (FFP)
69
Contraindication of Fresh Frozen Plasma (FFP)
Not appropriate as ____
volume expander
70
Shelf life of Fresh Frozen Plasma (FFP)
Frozen:
Thawed:
Frozen: 1 year or 7 years
Thawed: 37°C water bath for 24 hours
71
Storage temp of Fresh Frozen Plasma (FFP)
Frozen:
Thawed: ___ water bath followed by ____
storage after thawing
Frozen: -18°C or colder
Thawed: 30-37°C ; 1-6°C
72
Contents of Fresh Frozen Plasma (FFP)
All coagulation factors including 400 mg of Fibrinogen
73
Treatment of stable clotting factor deficiencies
Single donor plasma
74
Shelf life of Single donor plasma
Liquid: ____ beyond whole blood expiration
Frozen: ____
Liquid: 5 days
Frozen: 5 years
75
Storage temp of Single donor plasma
Liquid:
Frozen:
Liquid: 1-6°C
Frozen: -18°C or colder
76
Prepared from Fresh Frozen Plasma that is thawed at 30-37°C and stored at 1-6°C
Cold and soluble precipitate
Cryoprecipitated Antihemophilic Factor
77
Indicated by Hemophilia A, von Willebrand’s disease, Fibrinogen deficiency, Factor XIII deficiency (Stable clotting factor)
Cryoprecipitated Antihemophilic Factor
78
Shelf life of Cryoprecipitated Antihemophilic Factor
Frozen:
Thawed:
Pooled:
Frozen: 1 year
Thawed: 6 hours
Pooled: 4 hours
78
Storage temp of Cryoprecipitated Antihemophilic Factor
Frozen:
Thawed:
Frozen: -18°C or colder
Thawed: Room temp (20-24°C)
79
Contents of Cryoprecipitated Antihemophilic Factor
- Factor VIII:C -
- Factor VIII:vWF –
- Fibrinogen –
- Factor XIII –
- Factor VIII:C - 80-150 IU
- Factor VIII:vWF – 40-70%
- Fibrinogen – 150-250 mg
- Factor XIII – 20-30%
80
- Limited to patients that undergo CHEMOTHERAPY that is prone to NEUTROPENIA
- Patients with neutropenia is at risk in acquiring BACTERIAL and FUNGAL infections
- Prepared via apheresis as it provides high yield product compared when it is prepared via whole blood
Granulocyte Concentrate
81
Therapeutic dose of Granulocyte Concentrate
1.0 x10^10 per day
82
Indicated by severe neutropenia, Fever unresponsive to antibiotic/antifungal therapy, Myeloid hypoplasia of the bone marrow
Granulocyte Concentrate
83
Shelf life of Granulocyte Concentrate
24 hours
84
Storage temp of Granulocyte Concentrate
20-24 degC without agitation
85
Contents of Granulocyte Concentrate
≥ 1.0 x 10^10 WBC
86
Concentrates of plasma proteins that are prepared from pools of plasma
Plasma Derivatives
87
Given to patients with hemophilia A in relation to
FVIII deficiency
Factor VIII Concentrate
88
Shelf life of FVIII and FIX Concentrate
- ___ on the expiration date on the vial
- ___ prepared
Varies
Commercially
89
Storage temp of FVIII and FIX Concentrate
1-6 degC (lypholized)
90
Indicated by Hemophilia A
FVIII Concentrate
91
For patients with Hemophilia B relation to FIX deficiency
Factor IX Concentrate
92
Indicated by Hemophilia B
Factor IX Concentrate
93
- Primarily IgG antibody
- Used for patients with Congenital
Hypogammaglobulinemia
Immune Serum Globulin
94
Shelf life of Immune Serum Globulin
Depend on the route of administration
- Intramuscular:
- Intravenous:
- Intramuscular: 3 years
- Intravenous: 1 year
95
Indicated by Prophylactic treatment for those exposed to hepatitis, measles, and chicken pox, Hypogammaglobulinemia
Immune Serum Globulin
96
Indicated by Hypovolemic patients, Hypoproteinemic patient, Suffered from surgery, trauma and burns
Normal Serum Albumin
97
Shelf life and Storage of Normal Serum Albumin and Plasma Protein Fraction
3 years at ___
5 years at ___
20-24°C
1-6°C
98
Content of Normal Serum Albumin
96% Albumin
4% Globulin
99
Prepared the same as how NSA is prepared, however, PPF does not have as much as high albumin content
Indicated by Plasma volume expansion
Plasma Protein Fraction
100
Contents of Plasma Protein Fraction
85% Albumin
15-20% Globulin
101
RBCs are often modified into additional products needed for specific patient requirements
Performed using GAMMAIRRADIATOR
Irradiated blood
102
Irradiated blood
Gammairradiator uses:
- Cesium ___
- Cobalt ___ radioisotopes
137
60
103
Required Dose of Irradiation:
- 25 (gray) - in the ___ of the canister
- 15 (gray) – ____ or ___ dose
middle
lowest or minimum
104
Importance of Irradiating Blood (2)
- The donor unit is from a blood relative of the recipient
- The donor unit’s HLA match the patient
105
- Rh(D) Ig (Rhogam)
- Given to females that are Rh (-)ve that are
pregnant with Rh (+)ve child
RhoGAM
106
Shelf life and Storage of RhoGAM
3 years at 1-6°C
107
Content of RhoGAM
- Full dose: ___ Anti-D
- Mini dose: ___ Anti-D
- Full dose: 300ug
- Mini dose: 50ug
108
Indicated by Prevention of Rho (D) immunization
RhoGAM
109
Provide a safe alternative with regards to disease transmission because they are already sterilized and contain no human plasma
Synthetic Volume Expanders
110
Examples of Synthetic Volume Expanders (NEHRD)
- NSS
- Electrolyte Solution
- Hydroxyethyl starch (HES)
- Ringer’s lactate
- Dextran
111
Crystalloid
Ex:
IV Retention:
Peripheral Edema:
Pulmonary Edema:
Excretion:
Allergic Reaction:
Cost:
Ex: Ringer's lactate; 75% NSS
IV Retention: Poor
Peripheral Edema: Common
Pulmonary Edema: Possible
Excretion: Easily excreted
Allergic Reaction: Absent
Cost: Cheaper/ Inexpensive
112
Colloid
Ex:
IV Retention:
Peripheral Edema:
Pulmonary Edema:
Excretion:
Allergic Reaction:
Cost:
Ex: Dextran, Albumin, Hydroxyethyl starch (HES)
IV Retention: Good
Peripheral Edema: Possible
Pulmonary Edema: Possible
Excretion: Not easily excreted
Allergic Reaction: Rare
Cost: Expensive
