Transfusion stuff

Question 1

How is massive transfusion defined?

Answer 1

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

Question 2

How long can FWB be held at room temp without losing sig RBC or PLT function

Answer 2

24 hours

Question 3

How long can WB versus pRBC be stored at 2-6C?

Answer 3

Whole blood 35 days
pRBC 35-42 days

Question 4

List possible options to transfuse platelets

Answer 4

• FWB
• platelet-rich plasma
• platelet concentrate
• SWB (according to edwards et al can achieve maximum clot strength until 21 days)
• lyophilized platelets
• cryopreserved platelets

Question 5

How much are 10 mL/kg of FWB expected to increase a patients PLT?

Answer 5

by 10k /microL

Question 6

How long can PRP and fresh PC be stored for?

Answer 6

5 days at room temp

Question 7

What is the storage life of cryopreserved PLT?
What is added to the PLT?

Answer 7

• 80 degrees for 1 year

dimethyl sulfoxide (DMSO)

decreased quality and function + increase of activation during freeze-thaw process

Question 8

What is the storage life of lyophilized platelets?

Answer 8

24 months at room temp

costly and short PLT life-span

Question 9

List 3 ways in which RBC help Platelets with hemostasis

Answer 9

• rheology - pushing PLT to the periphery for endothelial contact
• produce platelet acitvators - e.g., TXA2, ADP
• NO scavenging by hemoglobin

Question 10

How soon after collection does plasma need to be separated from RBC?

Answer 10

within 8 hours

Question 11

What is FP24 and how do its coag factor activities compare to FFP?

Answer 11

Plasma from WB help at room or fridge temp for up to 24 hours and then separated

coag factor activity still above 50%

Question 12

What is liquid plasma?

Answer 12

Plasma separated but not frozen - stored up to 2 weeks

Question 13

What is the half-life of FP versus FFP and what is their difference in clotting factors?

Answer 13

FFP - 1 year
FP - 5 year - has lower activity of FVIII and FX

Question 14

What are the anticoagulants and RBC preservatives typically used for Blood products?

Answer 14

anticoagulant - CPD (citrate-phosphate-dextrose) or CPDA-1 (citrate-phosphate-dextrose-adenine-1)

RBC preservative - AS-1 Adsol or AS-5 Optisol

Question 15

List equations to determine pRBC doses

Answer 15

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

Question 16

List the equation to determin CSA doses

Answer 16

dose in g = 10 x (2.0 g/dL - patient albumin g/dL) x BW (kg) x 0.3

Question 17

How much mg/kg of CSA will increase a patients serum albumin by 0.5 g/dL?

Answer 17

450 mg/kg

Question 18

Which DEA antigen is the most immunogenic?

Answer 18

DEA 1

no naturally occuring alloantibodies

Question 19

What are the prevalences of DEA 3, 4, 5, and 7 and are the naturally occuring alloantibodies?

Answer 19

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

Question 20

What is the prevalence of DAL, Kai 1, or Kai 2 positive dogs?

Answer 20

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

Question 21

What cat breeds are more commonly type B?

Answer 21

50% of Turkish Van, Devon Rex, British Shorthair

Question 22

List preexisting factors that may predispose to TACO

Answer 22

• cardiac dysfunction
• renal failure
• pulmonary disease
• chronic anemia

Question 23

What is the maximum volume to be given through a 18 micrometer hemonate filter?

Answer 23

50 mL