8. Transfusion therapy Flashcards
(52 cards)
Routine AS RBC units are —- mL and have —% Hct
350 mL
60%
RBC increment
1 unit should increase Hgb 1 g/dL
apheresis unit platelet ct
3 x 10^11
random pooled unit platelet ct and dose
5 x 10^10
one dose is 6-10 units
platelet increment
1 unit should increase platelet count by 30-50,000
> 50,000 platelets
bleeding with procedure or trauma is unlikely
10-50,000 platelets
spontaneous bleed unlikely, likely with procedure or trauma
5-10,000 platelets
risk for spontaneous bleed
<5000 platelets
high risk for spontaneous bleed
platelet refractoriness
at least 2 transfusions fail to achieve ⅓ to ½ of expected increment
FFP increment
initial dose of 10-20 mL/kg expected to raise coagulation factors in a nonbleeding patient by 25-50%
—- FFP units usually control hemostasis
4-6
8-15 mL cryo contains…
150-250 mg fibrinogen
cryo increment
1 unit/10 kg expected to increase fibrinogen by 50 mg/dL if there is no ongoing consumption
usual cryo dose
10 units pooled
massive transfusion definition
replacement of patient’s total blood volume or more within 24 hours (8-10 units)
OR acute administration of 4-5 pRBC units in one hour
blood is drawn and stored prior to anticipated need; at least 72 hours before surgery
preoperative collection
blood is collected at the start of surgery and infused during or at the end; can contribute to decreased surgical bleeding by reducing hematocrit
acute normovolemic hemodiluation
shed blood is recovered from surgical field and then infused; surgical site cannot be abdominal due to bacterial contamination
intraoperative collection
blood is collected from drainage devices and infused
postoperative collection
only FDA approved usage is for heavy menstrual bleeding and short-term prevention in hemophilia pts
Transexamic acid (TXA)
sickle cell tx; (1) makes RBCs bigger, stabilizing them and making them less likely to take sickle shape; (2) blocks sickle Hb polymerization; both increase O2 carrying capacity and decrease adhesion (pain crises)
Hydroxyurea & Voxelotor
sterile, single use surgical tourniquet in use for bloodless orthopedic surgery
HemaClear
from large plasma pools; removal of antithrombin and FXI; 3-factor or 4-factor
prothrombin complex concentrate
