Transfusion Medicine Flashcards
Potential products that can be transfused?
- whole blood
- packed RBC
- fresh frozen plasma
- cryoprecipitate
- oxyglobin
when is whole blood used?
- bleeding on demand
- no separation and storage facilities
- substantial acute haemorrhage
- haemorrhage d/t haemostatic disorders
- cats
- oxyglobin?
What is in plasma that is useful?
Clotting factors
Ideal blood donor qualities?
- no travel hx
- healthy
- > 25kg dog
- preferably >5kg cat
- 1-8yo
- temperament
What infectious agents are always tested for ini cats?
- mycoplasma
- FIV
- FeLV
What is between the collection bag and the storage area of blood collections sets?
leucocyte reducing filter to v reaction of recipient
What is component therapy?
- multiple products from one donation (efficiency of donations, minimise side effects/risks of side effects)
Potential side effects of transfusion tx?
- volume overload
- transfusion reactions
What are packed RBC? How are hey made and stored?
- centrifuged whole blood
- plasma extactor
- addiive solutions
- stored at 1-6* c
Indications for packed RBC?
- cats
- anaemia with NO hypovolaemia
- anaemia with risk of volume overload
- oxyglobin??
How long can fresh frozen plasma be stored for?
- frozen up to a year
- must be separated within 24hrs
What is plasma high in?
Clotting factors (not platelets)
Indications for fresh frozen plasma?
- coagulopathies (rodenticide ,hemophilia)
- ?pancreatitis - shouldnt be, but often is indicated
- ?IG source
- ?albumin source
What is liquid/frozen plasma? How long can it be stored?
- dont know??!!
- refridgerated 24hrs - 6 weeks post collection
- frozen up to 5 years
- inadequate factors V, VIII, vWF (labile)
Indications for liquid/frozen plasma?
- rodenticide toxicity
- hemophilia B
- ?Albumin
What is cryoprecipitate? How big is one dose?
- prepared by partial thawing and centrifugation of FFP
> enriched in factor VIII, vWF and fibrinogen - donor can be given desmopressin (LOOK UP??)
- re-frozen and stored for up to a year
- one unit approx 60ml
What is cryosupernatent? uses?
> contains - vit K dependent clotting factors - albumin - anti-thrombin > uses - rodenticide toxicity - vit K deficiency - hemophilia B - hypoalbuminaemia?
What blood types exist for cats? dogs?
> Cats - A/B scheme (different to humans) - A, B or AB > Dogs - DEA scheme (DEA1,3,4,5,6,7)
How can DEA and AB type be worked out?
Paper test thingies
What re blood types?
- antigen on erythrocyte surface (proteins, glycoproteins, glycolipids, carbohydrate)
- foreign Ag -> Ab formation
Which animals need blood typing/testing? What tests are done?
- Dogs UK testing limited to DEA 1+/-
- full testing available in US
- Feline ALL CATS MUST BE TESTED (fatal reactions possible)
How is blood administration carried out practically?
> dedicated catheter - Drug reactions - Hartmanns > appropriate giving set > Slow initial rate - 0.5-1ml/kg/hr for first half hour - administer over 4-6hrs
What transfusion reactions are possible?
> immunological (allergi) v non-immunological (volume overload)
Acute (cats) v delayed (Dogs)
Clinical signs of a transfusion reaction?
- non-sepcific and do not indicate underlying cause
- monitor for:
- pyrexia, tachycardia, tachy/dys-pnoea, erythema, urticaria
Management of transfusion reactions?
- stop!
- check ECG And blood pressure
- symptomatic tx: adrenaline, CR, antihistamine, antipyretics
When is cross-matching indicated? Why?
- transfusion more thaan 4d ago (time to mount immune response)
- hx transfusion reactions
- recipients transfusion hx unknown
> blood groups not normally tested for, and likekly blood groups we dont know about!!
> This checks on a individual basis that blood is not going to react
What are the 2 types of crossmatching?
> major
- donor cells and recipient plasma
minor
- recipient cells and donor plasma
Confusing factors for blood typing?
- autoagglutination
- roulaeux
- cell washing
Indications for tranfusing a patient? LOOK SLIDES
- chronicity and severity of anaemia
- coping? tachycardia etc.
- underlying dz and prognosis
