Transfusions Flashcards
Normal PCV dog
37-55%
Normal TS dog
55-65g/L
Normal platelet level
150-800 * 10^9/L
How do you verify a very low platelet count?
blood smear
What leads you to want to transfuse a patient? 5
- chronic hx (acute anaemia not tolerated)
- v. low PCV (as other factors there is no absolute PCV value for transmission)
- other CS
- expected dz progression
What transfusion options are there?
- whole blood
- PRBCs
- fresh frozen plasma
- cryoprecipitate
- cryosupernanatant
- oxyglobin
What is whole blood?
- bleeding on demand
- no separating or storing facilities
- substantial acute haemorrhage
- haemorrhage d/t haemostatic disorders
- cats (you can’t buy separated blood products for cats)
- oxyglobin
What is the main reason to give plasma?
clotting factors
What is the ideal blood donor?
- healthy
- consider ethics
large (cats > 5kg, dogs > 25kg so can use human blood bags) - young (old animals more likely to have unknown underlying dz process)
- no hx foreign travel (ehrlichia)
- FIV/ FeLV negative (FIP hard to diagnose), Mycoplasma - cats, Dogs - A.vasorum (screening occurs but unknown if this travels in blood)
- friendly
- have received no transfusion themselves
- indoor?
- up to date (worming and vaccination?)
Function - leukocyte reducing filter
- to decrease # RBCs
- thought to reduce risk of transfusion reactions in humans
What is component therapy?
- get multiple products form one dontation (decreases # donations and increases money per donation)
- decreases risk of side effects (volume overload, transfusion reactions)
What is packed RBCs (pRBCs)?
- centrifuged whole blood
- plasma extractor
- additive solutions
- stored at -16 degrees
Indications - PRBCs
- anaemia without hypovolaemia
- anaemia w/o deficits in other components
- anaemia with risk of volume overload?
- Oxyglobin?
Describe fresh frozen plasma (FFP)
- separated within 24h
- frozen for up to 1 yr
- high in all clotting factors
Indications - FFP
- COAGULOPATHIES: rodenticide, haemophilia, warfarin
Inappropriate uses - FFP
- pancreatitis
- immunoglobulin source
- albumin sourve
Describe liquid/ frozen plasma
- refrigerated 24 hr to 6 wks post-collection
- frozen for up to 5 yrs
- inadequate factors (5, 8 and vWF)
Indications - liquid/ frozen plasma
- rodenticide
- haemophilia B
- albumin supply?
What is cryoprecipitate?
- prepared by partial thawing and centrifugation of FFP
- re-frozen and stored up to one year
- one unit approx. 60ml
- enriched in factor 8, vWF and fibrinogen
What can a cryoprecipitate donor be given to enhave release of vWF?
desmopressin
When do von Willebrand’s disease animals tend to bleed?
don’t tend to bleed spontaneously but during sx
What does cryosupernatant contain?
- vit K dependent clotting facotrs
- albumin
- anti-thrombin
Uses - cryosupernatant
- rodenticide
- vit K deficiency
- haemophilia B
- hypoalbuminaemia?
Name different PLT products
- whole blood
- PRP
- fresh platelet concentrate
- frozen platelet concentrate (cryopreserved)
- lyophilised platelets
What is anapharesis?
like blood donation but only PLTs removed as the blood is filtered and all parts of blood that isn’t PLT is returned to the body and only the PLTs are harvested
Lifespan - PLTs
6 days
What are the canine blood groups
DEA scheme (1,3, 4, 5, 6, 7) i.e. NO group 2
What are the feline blood groups?
Type A, B and AB
Why is blood typing important?
Ag on RBC surface is foreign –> Ab formation –> ‘foreign’ RBCs are destroyed
What Ags are present on RBC surface? 4
- proteins
- GPs
- glycolipids
- carbohydrates
How are canine blood types tested for?
- In UK testing is limited to DEA 1 or not, full testing in USA. Typing not essential for first transfusion. Typing for first transfusion could allow you to prolong how long the product will last. Keep blood sample from before first transfusion to type if going to receive >1 transfusion.
- feline donors and recipients MUST be typed
Method - blood administration
- Dedicated catheter: drug reactions, Hartmanns/ products containing Ca are CI’d
- appropriate giving set
- Slow initial rate: 0.5-1ml/kg/hr for first half hr
- Administer over 4-6 hrs
What types of transfusion reactions are there?
- Immunologcial vs. non-immunological
- acute vs. delayed
CS - transfusion reaction
- often non-specific
- don’t often show underlyign cause
- monitor for (i.e. TPR): pyrexia, tachycardia, tachy/dyspnoea, erythema, urticaria (swollen face)
Management - transfusion reaction
- stop transfusion
- check ECG and BP
- symptomatic tx: adrenaline and CPR, anti-histamines, anti-pyretics
How many days does it take for Ab to form against Transfused blood?
4 days
Why do blood transfusion reactions occur?
- blood groups exist that aren’t checked for
- possibly blood groups that aren’t known about
- overall Ab form
What are the types of cross-matching?
- MAJOR: donor cells and recipient plasma
- MINOR: recipient cells and donor plasma
Name 3 factors confusing blood typing
- autoagglutination
- rouleaux
- cell washing
What should you remember about blood products?
they are inherently variable
T/F: blood type if at all possible in dogs and ALWAYS in cats
True
