Transfusion Therapy Flashcards
What blood type is the universal recipient?
AB+
What blood type is the universal donor?
O-
What are the reasons to give a blood transfusion of a Hgb < 8
Surgical patient - orthopedic or cardiac surgery
Pre-existing CVD
Actively bleeding
One unit of PRBC’s will increase Hgb levels by how much (g/dL)
1.0
Is consent required in an emergent situation?
No
What must be done before a transfusion?
Type and Screen
How long is a type and screen good for?
72 hours
What are the components of whole blood?
Includes RBC’s, plasma, and platelets
When is whole blood transfusions indicated?
Massive transfusion to maintain ratio of blood components (10+ units in 24 hours)
What are the components of packed red blood cells?
Includes RBC’s, platelets, some residual plasma, some WBC
How long can frozen PRBC’s be stored for?
10 years
Why are PRBC’s given?
To raise hemoglobin/blood volume
What are irradiated red blood cells?
PRBC’s subjected to radiation
Who needs irritated RBC’s?
Immunosuppressed patients
Stem cell or bone marrow transplants
Intrauterine transfusions
Premature infants
First degree relative donors (HLA heterozygous getting HLA homozygous)
How long are platelets good for?
5 days
How can transfusion reactions be defined?
Non-hemolytic reactions and Hemolytic reactions
What is the typical presentation of transfusion allergic reactions?
Hives (wheels), rash, and itching
What are the typical presenting symptoms of a transfusion bacterial contamination?
Fever
Chills
Tachycardia
Hypotension
GI symptoms (nausea, vomiting, abdominal cramps)
What is acute hemolytic reaction in response to?
Result of transfusing ABO incompatible blood
What are the symptoms of hemolytic reactions?
Pain at infusion site
Facial flushing
Back and chest pain
What is the onset of delayed hemolytic reactions?
2-10 days after transfusion
What are the symptoms of Transfusion Related Acute Lung Injury (TRALI)?
Dyspnea
Hypoxemia
Fever
Rigors
Bilateral diffuse pulmonary infiltrates on CXR
What is the treatment for TRALI?
Stop transfusion and provide pulmonary support (O2 or ventilation)
What is Transfusion Associated Cardiac Overload (TACO) related too?
Rapid transfusion, especially with pre-existing cardiac disease
What are the symptoms of TACO?
Hypertension
Dyspnea and respiratory distress
Cough
Rales on auscultation (pulm edema)
What is the treatment for TACO?
Diureses
Reduce rate of transfusion or stop it
Mechanical ventilation if needed
**Reduce amount of IV fluids being administered during transfusion of blood products
What is the cause of transfusion-associated graft-versus-host-disease
Immune reaction produced by discordant HLA types
When can transfusion-associated graft-versus-host-disease present?
2-30 days
What are the possible presenting symptoms of transfusion-associated graft-versus-host-disease?
Fever
Rash
Diarrhea
Hepatitis
Lymphadenopathy
Pancytopenia
