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VET433: ECC & Toxicology > Transfusion > Flashcards

Transfusion Flashcards

1
Q

what are the 4 indications for transfusion

A
  1. anemia
  2. secondary coagulopathy
  3. thrombocytopenia
  4. hypoproteinemia (rare)
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2
Q

transfusing specific components vs whole blood

A

only want to transfuse the products that the patient needs
- packed RBCs
- platelets
- plasma

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3
Q

RBC transfusion indication

A

anemia

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4
Q

transfusion triggers for RBCs

A
  1. PCV = 20-22%
  2. ongoing losses (transfuse sooner)
  3. chronicity
  4. clinical response to anemia (transfuse later if patient compensating)
  5. underlying/concurrent disease
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5
Q

RBC products

A
  • fresh whole blood
  • stored whole blood
  • packed RBCs
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6
Q

transfusion volume - RBCs

A

goal: PCV = 25%

pRBCs: 1-1.5 mL/kg
whole blood: 2 mL/kg
(to increase PCV by 1%)

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7
Q

indications for plasma transfusion

A
  1. acquired secondary coagulopathy w/ serious bleeding (rodenticide, liver failure, heat stroke, DIC)
  2. bleeding w/ congenital coagulopathy
  3. clinical signs of secondary coagulopathy
  4. coagulation testing - prolonged PT/PTT, ACT, etc
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8
Q

products for transfusing plasma

A
  • fresh plasma: all factors
  • fresh frozen plasma: all factors
  • frozen plasma: stable factors (vit K dependent)
  • cryoprecipitate: labile factors
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9
Q

transfusion volume - plasma

A

10-15 mL/kg minimum
titrate to effect

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10
Q

indications for platelet transfusion

A
  1. severe thrombocytopenia w/ severe hemorrhage (<10,000)
  2. moderate thrombocytopenia w/ planned invasive procedure (>50,000)
  3. massive transfusions
  4. thrombocytopathy
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11
Q

platelet transfusion products

A

SHORT half life

  1. fresh whole blood
  2. platelet rich plasma
  3. platelet concentrate
  4. cryopreserved platelets
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12
Q

transfusion volume - platelets

A

1 unit/kg
titrate to effect

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13
Q

is it common to transfuse albumin?

A

no

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14
Q

what is blood type determined by

A

antigens present on RBC surface

genetically determined
species specific
antigenic in individuals that lack the same marker

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15
Q

what is the major dog blood type antigen

A

DEA-1

strongly antigenic
generates a strong alloantibody response AFTER sensitization

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16
Q

do dogs have naturally occurring antibodies against DEA-1

A

NO

DEA-1 negative dogs do NOT have natural antibodies against DEA-1

will develop antibodies AFTER sensitization (ex. previous transfusion with DEA-1 blood)

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17
Q

DEA-1 negative donors and recipients

A

donate to DEA-1 + and -
receive from DEA-1 - only

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18
Q

DEA-1 positive donors and recipients

A

donate to DEA-1 + only
receive from DEA-1 + and -

19
Q

when is crossmatching required for dogs

A

if transfusion has occurred > 3 days ago
OR
unknown history

recommended but not required for first transfusion

20
Q

what are the cat blood typing antigens

A

AB blood groups
MiK antigen

21
Q

type A cat blood

A

majority of DSH/DLH and non-pedigree cats

has WEAK anti-B natural antibodies

22
Q

type A donors and recipients

A

donate to A and AB
receive from A only

23
Q

type B cat blood

A

has STRONG anti-A antibodies

24
Q

type B donors and recipients

A

donate to B only
receive from B only

25
Q

what happens if type A blood is donated to a type B cat

A

marked hemolysis

B recipient has strong anti-A antibodies

26
Q

what happens if type B blood is donated to a type A cat

A

minor hemolytic reaction

A recipient has weak anti-B antibodies

27
Q

type AB cat blood

A

rare - certain purebred cats only

has type A and B antigen
NO naturally occurring antibodies

28
Q

type AB donors and recipients

A

donate to AB only
receive from A only

B blood will have a strong reaction against the A antigen

29
Q

when is crossmatching required for cats

A

ALL transfusions due to naturally occurring antibodies
and because MiK is not determined on blood typing - should cross match

30
Q

blood typing

A

identifies the primary red cell surface antigen of the donor and recipient

31
Q

crossmatching

A

identifies any blood group abnormalities beyond the single surface antigen

major: tests for antibodies in the recipient plasma against donor RBCS
minor: tests for antibodies in the donor plasma against recipient RBCs

32
Q

what to do in emergency situation (dogs and cats) if you do not have time to crossmatch

A

dogs: type OR give DEA-1 neg pRBCs

cats: type or watch for agglutination on slide
- if only A blood available - give anyway if patient will die without transfusion

33
Q

acute transfusion reactions

A

occurs within 24 hours of transfusion

34
Q

delayed transfusion reactions

A

occurs after 24 hours of transfusion

35
Q

febrile non hemolytic transfusion reaction (FNHTR)

A

increase in temperature with NO other clinical signs of reaction
- T > 39C (102.5F) and increase in temp >1C or 1.8F

MOST COMMON

36
Q

FNHTR pathogenesis and treatment

A

reaction to WBC or platelet antigen-antibody reactions NOT a reaction to the RBC antigen

tx: slow or stop transfusion and rule out other causes of fever - can restart

37
Q

acute hemolytic transfusion reaction (AHTR)

A

type II hypersensitivity reaction in which the recipient antibodies react with donor RBC antigen –> ACUTE LYSIS of transfused cells

leads to CV collapse, hemoglobinemia/uria, fever

38
Q

delayed hemolytic transfusion reaction (DHTR)

A

low levels or delayed production of antibodies causing a hemolytic reaction >24 hours after transfusion (slow hemolysis)

not common

39
Q

allergic reactions

A

type I hypersensitivity reaction to foreign proteins in blood

CS: urticaria, pruritus, swelling, GI signs, anaphylaxis

TX: slow or stop transfusion, diphenhydramine, epinephrine

do NOT give corticosteroids

40
Q

transfusion associated circulatory overload (TACO)

A

respiratory reaction

volume overload leads to hydrostatic pulmonary edema within 6 hours of transfusion

tx: O2 supplementation, ventilatory support, furosemide

41
Q

how to administer transfusion

A

use a filter on administration set

rate:
1. first 15 min: 2.5 mL/kg/hr
2. end goal: 5 mL/kg/hr

42
Q

transfusion monitoring

A

temperature
HR
RR
mentation
PCV +/- coags PRN

43
Q

are predmedications indicated to prevent allergic reactions

A

NO

VET433: ECC & Toxicology (9 decks)

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