PRBC, Platelets Flashcards

1
Q

What is the volume of Packed Red Blood Cells (PRBC)?

-Breakdown

A

350 mL

  • RBC (250 mL)
  • Plasma (50 mL)
  • AnticoagPreservative (50 mL)
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2
Q

How much Iron is in 1 Unit of PRBC?

-mL of Red Cells>

A

200 mg of Iron in 1 unit PRBC

-Each mL of Red Cells contains ~1 mg of Iron

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3
Q

What is the hematocrit in a unit of PRBC?

A

55-65%

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4
Q

PRBC:

  • Storage
  • Transport
A
  • 1-6 C (within 8 hours of collection)

- 1-10 C

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5
Q

PRBC - Expiration:

  • CPD
  • CPDA
  • AS+CPD
A

PRBC - Expiration:

  • CPD - 21 days
  • CPDA - 35 days
  • AS+CPD - 42 days*

*AS must be added within 72 hours of collection; used for PRBC only

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6
Q

PRBC - Expiration if opened (“spiked):

  • Refrigerated
  • Room Temp
A

PRBC - Expiration if opened (“spiked):

  • Refrigerated - 24 hours
  • Room Temp - 4 hours
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7
Q

PRBC - Mandatory Quality Control:

-Random Donor - Hematocrit

A

must be <80% for all units tested

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8
Q

PRBC - Mandatory Quality Control:

-Apheresis RBCs - Hemoglobin

A

must be >50 g (or 150 mL of red cell volume) in >95% of units tested

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9
Q

PRBC - Storage Lesions:

  • 2,3.DPG
  • Potassium
  • pH
  • ATP
  • Free Hemoglobin
A

PRBC - Storage Lesions:

  • 2,3.DPG - Decreased
  • Potassium (free) - Increased
  • pH - Decreased (acidic)
  • ATP - Decreased
  • Free Hemoglobin - Increased
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10
Q

Frozen RBCs:

-Must be frozen within

A

6 days if no additive solution

-before expiration date if additive solution present

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11
Q

Frozen RBCs:

-Cryoprotective agent

A

40% Glycerol

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12
Q

Frozen RBCs - Storage:

  • Temp
  • Expiration
A
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13
Q

Frozen RBCs - Thawed:

  • Wash
  • Storage
  • Expiration
A
  • Hypotonic solution removes glycerol
  • 1-6 C
  • Transfused within 24 hours
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14
Q

What is the expected effect of 1 unit of PRBCs?

*Pediatric dose

A

1 g/dL increase in Hemoglobin
-3% increased in Hematocrit

*Pediatric dose - 4 mL/kg

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15
Q

Platelet Transfusion Indications - Bleeding patient w/ thrombocytopenia:

  • Extracranial
  • Intracranial
A
  • <50,000 (extracranial)

- <100,000 (intracranial)

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16
Q

Like Red Cells, Platelets must always be transfused through what?

A

170 um filter

17
Q

T/F: Frozen/Deglycerized Red Cells are considered to be Leukoreduced and Washed.

A

True

18
Q

Platelets:

  • Storage
  • Transport
  • Expiration (closed)
  • Expiration (open)
A
  • 20-24 C w/ gentle agitation
  • Transport - w/o agitation for 24 hours
  • 5 days
  • 4 hours after opened
19
Q

Leukoreduced apheresis platelets:
-Number of leukocytes

*NON-apheresis platelets

A

<5x10^6 leukocytes (apheresis platelets)

*<8.3x10^5 (non-apheresis platelets)

20
Q

Single Donor Derived Platelets:

  • Volume
  • Fibrinogen
  • Minimum Platelets
  • pH
A
  • 50 mL
  • 80 mg fibrinogen
  • 5.5 x 10^10 platelets
  • pH>6.2
21
Q

Pheresis Platelets:

  • Volume
  • Fibrinogen
  • Minimum Platelets
A
  • 100 mL
  • 150 mg fibrinogen
  • 3.0x10^11 plateles

*Pheresis platelet unit has ~6X the number of platelets in a single donor derived unit

22
Q

Platelet Transfusion Indications:

-Nonbleeding patient

A

10,000/uL

23
Q

Platelet Transfusion Indications - Bleeding patient w/ thrombocytopenia:

  • Extracranial
  • Intracranial
A
  • <50,000 (extracranial)

- <100,000 (intracranial)

24
Q

Platelet Transfusion Indications - Surgical patient w/ thrombocytopenia:

  • Nonneurosurgical
  • Neurosurgial
A
  • <50,000 (Nonneurosurgical)

- <100,000 (Neurosurgical)

25
Q

Platelet Transfusion Indications:

-Functional Platelet Defects (4)

A
  • Glanzmann Thrombasthenia
  • Bernard-Soulier syndrome
  • Aspirin ingestion
  • Renal Failure*

*Trial of DDAVP or cryoprecipitate is indicated first in renal failure

26
Q

Platelet Transfusion:

-Relative Contraindication (1)

A

Immune Thrombocytopenic Purpura (ITP)

27
Q

Platelet Transfusion:

-Absolute Contraindication (2)

A
  • Thrombotic Thrombocytopenic Purpura (TTP)

- Heparin Induced Thrombocytopenic Purpura (HIT)

28
Q

What expected result of 1 unit of random donor platelets?

-Apheresis unit

A

Increase platelet by 5,000/uL

-30,000/uL (apheresis units)

29
Q

What is the average platelet lifespan?

A

9.5 days

30
Q

Like Red Cells, Platelets must always be transfused through what?

A

170 um filter

31
Q

Why is Rh matching recommended for platelets?

A
  • Platelets do NOT bear Rh Ags; but contaminating RBCs do

- If Rh Neg female of child bearing age recieves Rh Pos Platelets, administration of RhIg should be considered.