Blood Loss and Transfusions Flashcards Preview

Anesthesiology > Blood Loss and Transfusions > Flashcards

Flashcards in Blood Loss and Transfusions Deck (61):
1

What is a blood transfusion?

Transferring blood or blood based products from one individual to another of the same species

2

What is the purpose of a transfusion?

- Increase Hb content of blood
- Increase circulating volume
- Increase plasma albumin content
- Provide coagulation factors
- Provide functional platelets

3

What is the percentage of blood loss that is fatal?

50% total volume

4

Is losing 50% of hemoglobin fatal?

May not be but depends on the individual

5

What are the types of blood products?

- Fresh whole blood
- Packed red cells
- Fresh frozen plasma
- Cryoprecipitate
- Platelet rich plasma

6

What PCV does it have to be to be considered whole blood versus packed red cells?

Whole blood- 40%
Packed red cells- 70%

7

How do you increase Hb content of blood if TP is

Fresh whole blood

8

How do you increase Hb content of blood if TP is >3.5?

Packed red cells

9

How long do RBCs survive normally?

60-120 days

Less if there is an immune reaction

10

What is the percentage loss needed to require transfusions in an acutely bleeding patient?

>20% total volume
>10-15% if perioperative

11

Transfusions are requred at which PCV values for:

Acute anemia, chronic anemia, anemia with anesthesia

Acute anemia-

12

Are clinical signs or values more important when considering transfusions?

Clinical signs

13

Is a higher or lower Hb content needed in cases of organ dysfunction?

Higher!

14

What are the clinical signs of blood loss (acute or chronic)?

- Pale MMs
- Elevated HR
- Low BP
- Weak pulses
- Blood in surgical sponges or containers

15

Will acute blood loss always result in changes in PCV and TP?

No! Not reliable

16

How much blood does a standard surgical sponge contain?

~5mL

17

How is blood loss calculated from fluid in canisters?

mL= (PVC fluid x Vol fluid)/ Preop PCV

18

How much blood volume should be given in acute blood loss?

The same amount that was lost

19

What is the general rule for increasing PCV?

2mL whole blood/kg raises PCV by 1%

20

What is the calculation for volume of blood to be transfused?

([PCVreq-PCVhave]xblood volume)/PCVdonor

21

What are the empirical dosages for transfusions in dogs and cats?

10-40mL/kg Dogs
5-20 mL/kg Cats

22

What dosage should be started to test?

0.25mL/kg for 30 min to test reaction then it can be increased

23

When should a transfusion be completed by?

Within 4 hours

24

Can blood be mixed with LRS?

No- blood will clot due to Ca content

25

Should a separate IV port be used for blood products?

Yes

26

Can blood products be refrozen after they've been thawed?

NO- use it or lose it

27

Which blood product is inappropriate for increasing albumin content?

FFP

28

Which blood product should be used to increase albumin content?

Concentrated albumin

29

What is the disadvantage to using 5% human albumin?

Allergic reactions are commmon

30

What is the diadvantage to using canine albumin powder?

Very expensive

31

What products can be used to provide coagulation factors?

Cryoprecipitate (best option)
Fresh whole blood
Fresh plasma
FFP

32

Why should older products not be used to proved coagulation factors?

Certain more unstable coag factors will be lost

33

What is a concern when giving plasma (fresh or frozen)?

Allergic reaction or immunity against blood group antigens

34

What is the best blood product to provide functional platelets?

Fresh whole blood

35

Why should whole blood be stored/administered in plastic if you are using it for functional platelet transfusion?

Platelets will adhere to glass

36

Fresh whole blood should be given within ____hrs after collecting for functional platelet transfusions.

8 hours

37

Why wouldn't platelet rich plasma be given in a functional platelet transfusion?

Very difficult to obtain in vet med

38

What are some donor selection criteria?

1. Free of blood born diseases
2. Up to date on vaccines
3. Good physical condition
4. Young adult
5. Medium to large size
6. Castrated males or nulliparous females preferred

39

What are some complications of transfusions?

- Blood type incompatibility
- Allergic reaction
- Immune reaction

40

What are some side effects of transfusions?

- Circulation overload
- Transfusion related lung injury
- Citrate induced hypocalcemia
- Sepsis
- Infectious disease transmission

41

When are transfusions usually reserved for?

When it is necessary to save a life

42

What is seen in an acute blood type incompatibility?

Hemolysis and agglutination

Life threatening!

43

What is seen in slow blood type incompatibility?

Delayed or slow hemolysis with decreased lifespan of RBCs

44

What are the clinical signs of an acute transfusion reaction?

-Increased HR/RR, decreased BP, dyspnea
- Vomiting, tremors, wheals, urticaria, fever, pain
- Hemolysis, Hb-uria, renal failure, DIC, CV collapse

45

Will signs of acute transfusions reactions be increased or decreased while under anesthesia?

Decreased! Must observe closely

46

What is the treatment for an acute transfusion reaction?

STOP!

Treat everything else symptomatically

47

Which two blood types in dogs have strong antigenic responses?

DEA 1.1 and 1.2

48

Are there naturally occurring antibodies in dogs against blood types?

No, this means that the first incompatible transfusion is usually fine but the second can be fatal

49

What are the three feline blood groups and which are most common?

A- most common
B- more rare but common in certain breeds
AB- typically pure breed cats

50

Do cats have naturally occurring blood antigen antibodies?

Yes! This means blood typing is compulsory

51

What is the other blood system in cats and do we care?

Mik, and no

52

What are the most antigenic equine blood groups?

Aa and Qa

53

Is blood typing and cross matching easy on equines?

No

54

What kinds of horses are most likely to have antibodies against blood types?

Mares that have fouled- neonatal isoerythrolysis concerns

55

What kind of horses are the best for donors?

Geldings or nulliparous mares of the same breed

56

What is cross-matching and what is the reaction observed?

Determines serological compatibility, look for agglutination

(agglutination is a positive reaction- do not use!)

57

What is the difference between a major and minor cross match?

Major- donor RBC + recipient plamsa
Minor- recipient RBC + donor plasma

58

What is oxyglobin?

Chemically stabilized bovine hemoglobin

59

What is oxyglobin used for?

Treat anemia in dogs

60

What is oxyglobin's duration of effect?

Min 24 hours

61

What are some concerns of using oxyglobin?

May cause circulatory overload, allergic reaction on repeated dosages, and give the appearance of jaundice