Tranfusion Flashcards
For the ABO system, what is A traits?
RBC antigen: A
Plasma antibiodies: Anti - B
Compatibility: O, A
For the ABO system, what B traits?
RBC antigen: B
Plasma antibodies: Anti-A
Compatibility: B and O
For the ABO system, what is AB traits?
RBC antigen: A, B
Plasma antibodies: none
Compatibility: A, B, AB, O
In the Rh system, what does Rh-positive mean, what does Rh-negative mean?
Rh positive: RBC antigens ~ D; antibodies ~ none; compatibility ~ Rh negative or Rh positive
Rh negative: RBC antigens ~ none; plasma antibody ~ anti-D; Rh negative compatibility
What is the Universal DONOR of RBC?!
O negative
What is the universal receptor of RBC?
AB positive
What is the universal donor of plasma?!
AB positive
What is the universal acceptor of plasma?
O negative
What is typing?
Determines the presence of ABO and Rh-antigens
- takes 5 mins
What is screening?
Determines the presence of the most clinically significant antibodies
(Takes 45 mins)
What is cross matching?
Provides the most accurate determination of compatibility by MIXING the recipient’s plasma with blood in the actual unit
**45 mins
What is the recommended order for administering uncrossmatced blood? (In most to least favorable)
- Type specific partially crossmatched blood
- Type specific uncrossmatched blood
- Type O negative uncrossmatched blood
How much is a 5 bag pool of cryo supposed to increase fibrinogen?
5 > 50
(5 bags should increase fibrinogen by 50 mg/dL)
How much platelets should you give a patient?
1 pack per 10 kg/body weight
What has the highest risk of bacterial contamination?
Platelets!
At what Hct should patients with significant coronary heart disease he transfused at?
28-30%
What is the blood volume for a premature infant?
95ish mL/kg
What is the blood volume for a term infant?
85ish mL/kg
What is the blood volume for an infant ~ past term?
80ish mL/kg
What is the blood volume for a school aged-child?
70 mL/kg
What is the blood volume for an adult?
70 mL/kg
What is citrate in PRBCs necessary for?
Anticoagulant
What is dextrose in PRBCs necessary for?
Substrate for glycolysis
What is the phosphate in PRBCs necessary for?
Buffer
What is the adenine in PRBCs necessary for?
Substrate for ATP synthesis
What is the Hct of 1 unit of PRBCs?
70%
How much does one unit of PRBCs increase hemoglobin/hematocrit?
1 g/dL or 2-3%
What does leukoreduction do?
Removes WBCs from banked RBCs and platelets
What does washing do to blood products?
Removes any remaining plasma ( and antigens) in the donor RBCs
Prevents anaphylaxis in Ig-A deficient patients
What is irradiation to blood products?
Exposes units to gamma radiation > disrupts WBC DNA in the donor cells and destroys donor leukocytes
***prevents graft vs host disease
This protects patients with leukemia, lymphoma, DiGeorge syndrome, etc…
What are the most common infectious transfusion reactions in most to least common?
Cytomegalovirus > hep B > hep C > HIV
What is the treatment of an acute hemolytic reaction?
Stop the transfusion
Maintain urine output > 75-100 mL/hr
Alkalinize the urine (bicarb)
Send urine and plasma hemoglobin samples
Check labs (platelets, fibrinogen, PT)
What is the pathophysiology to transfusion-related acute lung injury (TRALI)?
Donor antibodies > neutrophil in lungs > endothelial injury > cap leak > pulmonary edema > impaired gas exchange > hypoxemia > acidosis > death
What is TACO?
Transfusion associated circulatory overload!
State of volume overload caused by expanding volume beyond the patient’s compensatory ability
Tacos are salty > bad for CHF!!
What is the lethal triad?!
Coagulopathy
Hypothermia
Acidosis
What is the final Hct count of salvaged blood?
60-70%
Which has the better oxygen-carrying capacity? Salvaged blood or banked?
Salvaged!
They contain higher counts of 2,3 DPG and ATP!
What are contraindications to salvages blood?
Sickle cel
Thalassemia
Topical drugs
Infected sites
Oncologist procedures
