Unit 9 Flashcards
During packed red blood cell storage, is there an increase or decrease in pH? Why?
Decreased pH due to carbon dioxide accumulation and glucose being converted to lactate via anaerobic metabolism
During packed red blood cell storage, is there an increase or decrease in 2,3-DPG ? Why?
Decreased 2,3 DPG and ATP and a left shift in the OxyHgb curve
During packed red blood cell storage, is there an increase or decrease in potassium? Why?
Increased - K moves out of the RBC’s to help maintain neutrality due to the increased hydrogen atoms
Which mesh like structure covers endothelial cells that regulates permeability?
Glycocalyx
Which Ig antibody is responsible for blood transfusion reactions?
IgA
If a patient requires future blood transfusions after experiencing an allergic reaction, what can be done to help prevent it?
Washed cells
If a patient is having a minor reaction to packed cells, should it be stopped?
No - minor reactions can continue
Treat with IV fluid and antihistamines
Which infectious agent is highest in the United States with blood product transfusion?
Cytomegalovirus
Fluid concentrations
Is a patient at risk for a reaction who has never received blood products before?
Electrolyte abnormality
How is hypercalcemia treated?
Fluids and loop diuretics
Which electrolyte abnormalities has shorted QT interval?
Hyperkalemia
Hypocalcemia
Will also have a wide QRS
Which type of fluid is best for a packed cell carrier?
0.9% - do not want anything with calcium in it
Do not use LR because calcium is added in
Which electrolyte should be given after multiple products are given?
IV calcium
How does giving a antifibrinolytic helpful during cardiac surgery?
Decreases the need for a blood transfusion
What are examples of antifibrinolytics? How do they work?
TXA + Aminocaproic acid
They decrease bleeding by binding to plasminogen which inhibits the activation of plasmin
If a patient develops HIT which medication is a good alternative?
Give nonheparin anticoagulation such as
Argatroban
or
Bivalirudin
How is the antibody screen performed?
Serum from the recipients and mixed with commercially supplied blood
How is the crossmatch performed?
Serum from the recipients and mixed with the donor’s blood
Will old RBCs display decreased membrane flexibility and decreased O2 delivery?
Yes
In stored blood, does potassium in the intracellular space or the supernatant increase?
In stored blood, potassium leaves the intracellular space and moves to the supernatant
SO
**
Intracellular K decreases and
K in the blood product increases
What is removed during cell saver?
Plts and clotting factors
These may need to be replaced separately
