Transfusion Effects in Selected Patients Flashcards
What are the two instances where transfusion of blood components may be used to support a patient?
- Hematological problems
- Rapid blood loss
What are the adverse side effects of mass transfusions?
- Citrate toxicity
- Hypothermia
- Coagulation abnormalities such as consumption and dilutions
What three things that will be affected due to severe blood loss?
- Electrolyte metabolism
- Oxygen transportation
- Stress on organs - increased heart rate
What is the goal of transfusing a patient who is experiencing severe blood loss?
- Prevent hypovolemic shock
What risks might be seen due to hemorrhagic shock?
- Organ failure
- DIC
What is the method called, by which the patients blood is circulated outside of the body during cardiopulmonary bypass surgery.
Extracorporeal membrane oxygenation (ECMO)
What must a patient be on while undergoing a bypass surgery and why?
Heparin, because activation and thrombosis occurs in the ECMO process.
What is the risk of heparin excess?
Prolonged aPTT
How is heparin excess corrected?
- Protamine treatment
When would we use frozen plasma for heparin excess?
Only when the patient has a serious bleed during surgery or shortly after to replace coagulation factors.
When is HgbF usually converted to adult Hgb?
32-34 weeks gestation
What is the biggest issue in premie’s and what is it?
Iatrogenic blood loss - caused by excessive blood collecting.
Where is EPO produced for newborns?
Liver
What are the symptoms of hypovolemia in newborns?
- Cessation of breathing
- Apnea
- Metabolic rate
- Hypoglycemia
- Acidosis
What criteria have to be met in order to give newborn units of blood products?
- Irradiated
- Washed or fresh cells (<7 days)
- ABO compatible
- CMV negative
- Leukoreduced
What is iatrogenic blood loss?
Over collecting blood from neonates resulting in anemia
Which antigens are responsible for acute/chronic graft rejections?
ABO antigens
What is the usefulness of hematopoietic progenitor cell transplants?
- Aplastic anemia
- Marrow failure
- Leukemia
- Lymphoma
- Hodgkin’s disease
- immunodeficiency syndrome
Where are hematopoietic progenitor cell derived from?
- bone marrow
- Peripheral blood
- umbilical cord blood
what are the symptoms of GVHD?
- rash
- diarrhea
- jaundice
- fatal when untreated
What is therapeutic apheresis?
Removal of abnormal cells, plasma or plasma constituents
What is therapeutic plasma exchange? What purpose does it serve?
Plasma is removed from the PT and the blood cellular components are returned. To remove pathologic proteins
In therapeutic plasma exchanges what is critical to ensuring the patient doesn’t go into hypovolemic shock?
Plasma that is removed should be replaced with albumin, donor plasma or 0.9% NaCl
What are symptoms of citrate toxicity?
- Numbness
- Oral tingling
- Nausea
- Light headed
- ECG changes
