Transfusion Medicine Flashcards
does giving blood or oxygen have a greater impact on oxygen content?
blood
what does increasing stroke volume lead to?
higher systolic pressure
greater pulse pressure difference: bounding femoral pulses
what are the two forms in which blood carries oxygen?
dissolved
bound to oxyhemoglobin
when is fresh whole blood used?
directly after collection: 8-12 hours
does stored whole blood have advantages over red cells and plasma?
no
what is contained in packed red blood cells?
red blood cells
white blood cells
nonviable platelets
how long does fresh frozen plasma contain all of the procoagulant and anticoagulant proteins, von willebrands factor, albumin, globulin, and electrolytes?
a year
what are the indications for plasma?
coagulopathy
resuscitation in trauma
hypoproteinemia
stabilization of endothelial glycocalyx
what does prolonged storage of plasma lead to?
loss of factor V and VIII
what is cryoprecipitate rich in?
von willebrands factor
factor VIII
factor XIII
fibrinogen
fibronectin
what are the uses of cryoprecipitate?
hemophilia A
von willebrands factor deficiency
fibrinogen defect
what is the in vivo half life of platelet rich plasma and platelet concentrate?
about 4 days
which dog blood types are most antigenic?
DEA 1.1 and 1.2
what blood type are most dogs?
DEA 1 negative
what percentage of dogs are dal positive?
93%
what blood types do cats have?
A
B
AB
what happens in neonatal isoerythrolysis in cats?
type A drink colostrum containing anti-A alloautibodies from their type B queen
what is mik?
additional feline blood group
mik antigen
what does crossmatching detect?
incompatibilities between donor and recipient
what does older blood have more of?
free iron
free hemoglobin
ammonia
cytokines
microparticles
what vitals and bloodwork values should make you think about doing a transfusion?
tachycardia
tachypnea
weak pulses
hypotension
hyperlactatemia
PCV: patient dependent
what are the clinical signs of allergic reactions?
vomiting
urticaria
pruritus
what causes transfusion-related acute lung injury?
white blood cells from donor react with white blood cells from recipient
inflammatory mediators during storage
what is the response of the heart to anemia?
increase cardiac output
increase heart rate and stroke volume
what is the formula for oxygen carried in blood?
(Hb x % saturation x 1.34) + (PaO2 x 0.003)
how long can whole blood be stored?
35 days
when are platelets lost in whole blood?
2-4 hours
what is the shelf life of packed red blood cells?
42 days max
when does fresh frozen plasma need to be frozen?
within 8 hours
when might plasma be used for hypoproteinemia?
very small dogs
can plasma be used to stabilize the endothelial glycocalyx?
yes: sepsis, SIRS, high volume resuscitation
is frozen plasma good for vitamin K toxicity?
yes
not other specific procoagulant proteins
what is the in vivo half life of platelets in most products?
4 days
2 days if frozen
what is the minimum albumin for adequate oncotic function?
> 2.0 g/dL
TP >3.5 g/dL
how much albumin is intravascular?
30-40%
how should you test for crossmatching with an IMHA patient with auto-agglutination?
wash red blood cells of patient
choose DEA 1.1 negative
use freshest blood
what is added to blood for donation?
citrate: anticoagulant
phosphate: buffer
dextrose: ATP generation
adenine: substrate for RBC synthesis of ATP
what does the volume of a blood transfusion in a dog depend on?
body weight of patient
what are the categories of transfusion reactions?
immunologic
non-immunologic
what is febrile nonhemolytic transfusion reaction?
immune reaction against donor white blood cells, platelets, cytokines
pause transfusion and start at lower rate
what type of reaction is acute hemolytic transfusion reaction?
type II hypersensitivity
complement mediated
what are the clinical signs of transfusion related acute lung injury?
sudden respiratory distress
noncardiogenic pulmonary edema
absence of fluid overload
