Transfusion stuff Flashcards
How is massive transfusion defined?
volume transfused over 24 hours that is greater than or equal to the patient’s blood volume
or
half of the patient’s blood volume over 3 hours
How long can FWB be held at room temp without losing sig RBC or PLT function
24 hours
How long can WB versus pRBC be stored at 2-6C?
Whole blood 35 days
pRBC 35-42 days
List possible options to transfuse platelets
- FWB
- platelet-rich plasma
- platelet concentrate
- SWB (according to edwards et al can achieve maximum clot strength until 21 days)
- lyophilized platelets
- cryopreserved platelets
How much are 10 mL/kg of FWB expected to increase a patients PLT?
by 10k /microL
How long can PRP and fresh PC be stored for?
5 days at room temp
What is the storage life of cryopreserved PLT?
What is added to the PLT?
- 80 degrees for 1 year
dimethyl sulfoxide (DMSO)
decreased quality and function + increase of activation during freeze-thaw process
What is the storage life of lyophilized platelets?
24 months at room temp
costly and short PLT life-span
List 3 ways in which RBC help Platelets with hemostasis
- rheology - pushing PLT to the periphery for endothelial contact
- produce platelet acitvators - e.g., TXA2, ADP
- NO scavenging by hemoglobin
How soon after collection does plasma need to be separated from RBC?
within 8 hours
What is FP24 and how do its coag factor activities compare to FFP?
Plasma from WB help at room or fridge temp for up to 24 hours and then separated
coag factor activity still above 50%
What is liquid plasma?
Plasma separated but not frozen - stored up to 2 weeks
What is the half-life of FP versus FFP and what is their difference in clotting factors?
FFP - 1 year
FP - 5 year - has lower activity of FVIII and FX
What are the anticoagulants and RBC preservatives typically used for Blood products?
anticoagulant - CPD (citrate-phosphate-dextrose) or CPDA-1 (citrate-phosphate-dextrose-adenine-1)
RBC preservative - AS-1 Adsol or AS-5 Optisol
List equations to determine pRBC doses
pRBC (ml) = PCV rise desired (%) x 1.5 x body weight (kg)
pRBC (ml) = [(desired PCV - patient PCV) / donor unit PCV] x blood volume (mL/kg) x BW
List the equation to determin CSA doses
dose in g = 10 x (2.0 g/dL - patient albumin g/dL) x BW (kg) x 0.3
How much mg/kg of CSA will increase a patients serum albumin by 0.5 g/dL?
450 mg/kg
Which DEA antigen is the most immunogenic?
DEA 1
no naturally occuring alloantibodies
What are the prevalences of DEA 3, 4, 5, and 7 and are the naturally occuring alloantibodies?
DEA 3
- 6-7 % positive
- alloantibodies in 20% of DEA 3 neg dogs
DEA 4
- >99% of dogs are DEA 4 positive
- alloantbodies not identified
DEA 5
- 11% positive
- alloantibodies in 10% - if present can cause delayed clearance of RBC within 3-5 days
DEA 7
- 10-55% positive
- alloantibodies in 0-38% - unlikely clinically important
What is the prevalence of DAL, Kai 1, or Kai 2 positive dogs?
most breeds DAL positive (93%)
Neg reported in: Dalmatians, Doberman, Shih Tzus, Lhasa Apsos, Beagles, Bichon Frises, MBD
- no alloantibodies reported
94% Kai 1 pos and Kai 2 neg
- no alloantibodies identified for either
What cat breeds are more commonly type B?
50% of Turkish Van, Devon Rex, British Shorthair
List preexisting factors that may predispose to TACO
- cardiac dysfunction
- renal failure
- pulmonary disease
- chronic anemia
What is the maximum volume to be given through a 18 micrometer hemonate filter?
50 mL
