Transfusion Medicine Flashcards
When platelet counts drop below what level is platelet transfusion recommended?
100,000
What is dilutional coagulopathy?
Dilution of coagulation factors due to massive blood transfusion that are often deficient in clotting factors and platelets
What is the universal blood donor?
O-
What characterizes transfusion associated circulatory overload?
Respiratory distress secondary to cardiogenic pulmonary edema due to fluid overload
What electrolyte abnormalities may present with large volume transfusions?
Hypocalcemia - due to citrate as an anticoagulant
Hyperkalemia - release of potassium while cells are stored
What patients are most at risk for transfusion associated circulatory overload?
Patients with congestive heart failure or acute renal failure
What blood components are available for transfusion?
Packed RBCs, platelets, fresh frozen plasma, cryoprecipitate, granulocytes
In adults, how much will Hb increase with administration of one unit of packed RBCs?
1 g/dL per unit of pRBCs
What blood component is administered in cases of severe bleeding to replace lost coagulation factors?
Fresh frozen plasma
Approximately how much will platelet count increase with transfusion of one unit of platelets?
25,000 - 50,000/uL
What is the universal blood recipient?
AB+
This is administered to Rh - mothers with a Rh+ fetus to prevent loss of pregnancy.
RhoGAM - prevents hemolytic disease of the newborn
What is the clinical indication for cryoprecipitate transfusion?
Fibrinogen deficiency
True/False. As compared to pRBCS, fresh frozen plasma does not need to be ABO or Rh compatible.
False - Fresh frozen plasma must be ABO compatible, but does not need to be Rh compatible
What are possible complications of blood transfusions?
Infection, hemolysis, allergic reaction, febrile reactions, transfusion-related lung injury
While still very low risk, which virus is most likely to infect via blood transfusion?
Hepatits B
How can febrile reactions due to transfusion be prevented?
By administering leukocyte-reduced blood products
What is the clinical presentation of transfusion related lung injury (TRALI)?
Approximately 2-4hrs after transfusion, acute hypoxemic respiratory distress with pulmonary edema and patch lung infiltrates, but normal venous pressure
What is the most common complication of blood transfusions?
Febrile reactions
Allergic reactions of transfusion often present with hives and itching. What is the pathophysiology?
Exposure to donor IgA
At what hemoglobin level is blood cell transfusion standardly recommended?
7 g/dL
What is the cause of acute hemolytic transfusion reactions?
Incompatible RBCs (usually ABO incompatible)
