Flashcards in Blood Component Therapy Deck (73):
What are the two methods to get blood?
What is apheresis?
Drawing off plasma from RBCs
What happens to a unit of donated blood after it is spun?
Draw off plasma/platelets, and spin that to just get plasma
pRBC are used for what?
Transfusions for Hb, or replaced after acute bleeding
What happens to potassium are pRBCs are stored
What happens to RBC deformability are pRBCs are stored
What happens to 2,3 BPG are pRBCs are stored
What happens to ATP are pRBCs are stored
What happens to glutathione are pRBCs are stored
What happens to NO levels are pRBCs are stored
Is there a clinical difference if giving older pRBCs compared to fresh pRBCs?
Which is has shown to provide better outcomes: transfusing at low Hb thresholds, or higher ones?
What is the Hb threshold for: a symptomatic pt?
What is the Hb threshold for: preexisting CAD?
What is the Hb threshold for: acute coronary syndromes?
What is the Hb threshold for: heart failure?
What is the Hb threshold for: ICU pts?
What is the Hb threshold for: GI bleeds (stable)?
What is the Hb threshold for: pts with non-cardiac surgery
What is the Hb threshold for: cardiac surgery
What is the Hb threshold for: oncology pts in treatment?
What is the Hb threshold for: the palliative care setting?
PRN for symptom management
What is the purpose of leuko-reducing units of blood?
Prevent fever, HLA alloimmunization, viruses
What is the specific virus that is concerning and a reason for performing a leukoreduction? Why?
CMV--carried in WBCs
True or false: Leukoreduced units are considered CMV negative
True or false: you have to specifically request leukoreduced RBC units in the US
False--virtually all RBC units in the US are leukoreduced
What is the purpose of irradiating pRBCs?
Prevent transfusion associated GVHD
What is the major indication for irradiating pRBCs?
If the pt is immunocompromised
What is the purpose of washing RBCs?
Remove IgA, or other allergic parts of plasma
What is volume reduction used for?
When circulatory overload is a concern
What are the indications for giving plasma?
1. Coagulation factor replacement
2. Massive tranfusions
True or false: it is rare that pts make antibodies to transfused platelets
What are the two antigens that pts make antibodies against when given platelets?
What is the concern with developing an immune rxn to platelets?
In future transfusions, the transfused platelets may be quickly destroyed
What is the treatment for refractory platelets?
1. Give random platelets units
3. Find platelets that do not have the antigen that the antibody is directed toward
What is alloimmune platelet refractoriness?
Destruction of transfused platelets
What is non-alloimmune platelet refractoriness?
What is in cryoprecipitate?
When is cryoprecipitate used?
Fibrinogen replacement in bleeding pts
What is the process to make plasma derivatives?
What is prothrombin complex concentrate?
plasma concentrate that has factors
What fraction of the plasma concentrate does factor VIII come from?
What fraction of the plasma concentrate does IgG come from?
II and III
What fraction of the plasma concentrate does factor albumin come from?
When is prothrombin complex concentrate given?
To pts with hemophilia
When is recombinant factor VIII given?
Pts with hemophilia A
What is IVIG given?
Primary humoral immunodeficiencies
When is albumin given?
PRotein losing enteropathy
What is a massive transfusion?
replacement of entire RBC volume in 24 hours
REplacement of 50% of a pts total blood volume in 3 hours
What is the major issues with massive transfusions?
Coagulation abnormalities caused by dilution of existing platelets
What is the major issue with directed donation?
Riskier since the donor is more likely to be untruthful (since they want to help pt)
True or false: whole blood is rarely used in the US
What is the primary advantage of giving whole blood?
Has all three components of the blood
When is whole blood generally used?
What is the first step to take if you suspect a transfusion rxn?
Stop the transfusion and keep the line open with saline
What is the pathophysiology of febrile transfusion reactions?
Cytokine release from leukocytes in the transfused blood
What is the presentation of febrile transfusion rxns?
Temp increase of >1C above 37C with no other etiology
How long can febrile transfusions present after transfusion?
up to 4 hours after
How do you prevent febrile transfusion reactions?
What is the pathophysiology of an allergic TR?
Preformed IgE against the RBCs that are transfused
What type of transfused material usually causes an allergic TR?
Plasma d/t platelets
What specific disease is a common cause of anaphylaxis post transfusion
Does pretreatment work for allergic reactions to transfusions?
What is the treatment for allergic TR?
What is transfusion-associated circulatory overload?
Volume overload d/t transfusion
What is the most presentation of TACO?
increased BP and HR
What is the platelet transfusion threshold for: an active bleed?
What is the platelet transfusion threshold for: DIC or a CND bleed?
What is the platelet transfusion threshold for: neurosurgery?
What is the platelet transfusion threshold for: eye surgery?
less than 100,000
What is the platelet transfusion threshold for: major surgery (outside of eye or neurosurgery)
less than 50,000
What is the platelet threshold for central line placement?
less than 20,000