Flashcards in Blood Component therapy II Deck (46):
What is the pathophysiology of transfusion related acute lung injury? (2 hits)
PMN sequestration and priming--where they respond to a weak stimulus in the lungs
PMN activation and ROS generation
What are the antibodies that are involved in TRALI?
What is the presentation of TRALI?
Less than 6 hours after transfusion
What are the official diagnostic criteria for TRALI? (4)
No evidence of acute lung injury prior to transfusion
Onset within 6 hours of transfusion cessation
What is the leading cause of transfusion related mortality in the US?
What is the treatment for TRALI?
SHould you give diuretics for TRALI? TACO?
Yes for taco, no for TRALI
How do you prevent TRALI?
only allow donors who are at minimal risk for HLA/HNA antibodies
Who are the donors who are at low risk of giving blood that can cause TRALI?
Which has hypotension, and which has elevated BP: TACO vs TRALI
TACO = increased
TRALI = lower
Who is most at risk of developing TACO?
Pts already at risk for volume overload
What is the pathophysiology of acute hemolytic TR?
Antibodies in the pt against antigens on the transfused RBCs, leading to intravascular destruction
Is acute hemolytic TR intravascular, or extravascular?
How does acute hemolytic TR present? (3)
CVA TTP (kidney dmg)
How do you treat acute hemolytic TR?
How do you prevent hemolytic TR?
Prevent clerical errors
What is the pathophysiology of delayed hemolytic TR?
Pt has a lower titer of ab and recent transfusion is causing an increase
What is the classic antibody that is seen in delayed hemolytic TR?
Is delayed hemolytic TR extravascular or intravascular?
How long does it take for delayed hemolytic TR to present?
Extravascular hemolysis presents how?
What is the treatment for delayed hemolytic TR?
What is the pathophysiology of posttransfusion purpura?
pt has anti-platelet antibodies d/t previous exposure to foreign platelets (prego)
How long does it take for posttransfusion purpura to present?
9 days ish
What are the symptoms of posttransfusion purpura/
Mortality associated with posttransfusion purpura is usually caused by what?
What is the treatment for posttransfusion purpura?
What is the pathophysiology of transfusion associated GVHD?
Blood component donor has a different HLA-type from the recipient
T cells in the component attack host's HLA cells
Who is at risk of developing TA-GHD?
How does TA-GVHD present? (3) How long?
3-30 days post transfusion
What percent of TA-GVHD are fatal?
The risk of developing TA-GVHD is higher or lower with a very diverse population?
How do you treat TA-GVHD?
How do you prevent TA-GVHD? What is the issue with this?
Irradiate RBCs--decreases shelf life of blood
How long does it take for TTBI to present?
immediate to 5 hours
TTBI is usually associated with giving what blood component? Why?
Since they are stored at room temp
What is the presentation of TTBI?
Which type of bacteria cause a more severe rxn: gram positive or negative?
To be considered 100% diagnostic for TTBI, what must you do?
Identify same bacteria in blood cultures as the transfused blood component
Why is it that you have to throw out the first few milliliters of blood taken?
Get rid of skin plug
How do you prevent TTBI?
Culture platelets for 24 hours, and ensure negative
What are the TRs that present with a fever?
What is erythroblastosis fetalis?
Hemolytic disease of the newborn
What is RHOgam?
anti D antibody, that will bind to fetal RBCs, and in maternal blood, and prevents immune response from mom
Can you give RHOgam in moms who've already had HDNB