Flashcards in Blood Products Deck (157):
What are the three kinds of blood products?
Whole + Plasma + Platelets
Products: Whole blood
Fresh or Stored = Packed RBC's
Fresh frozen plasma
-- and --
Fresh whole blood
Platelet rich plasma
What is the dose for whole blood?
1ml per pound per point PCV
How much crystalloid isotonic fluid needs to be given to off set loss of 100 ml of water?
300 ml of crytalloids
What is within whole blood?
RBC's + WBCs + Clotting factors + Albumin + Platelets
What happens when you refrigerate whole blood?
WBCS + Platelets become non-functional
When should whole blood be given?
Anemia + Hypoproteinemia + Thrombocytopenia
What is within packed RBC's?
RBCs + Small amount of plasma + Anticoagulant
How much packed RBCs does 450 ml whole blood give?
What is the dose for packed RBCs?
6 to 10 ml/kg
What is the reason for giving packed RBC's?
Clinically symptomatic anemia
How soon after collection does fresh plasma need to be frozen
When is fresh frozen plasma used?
replace coagulation factors + immunoglobulin is needed
Inherited factor deficiencies
What should fresh frozen plasma not be used for?
What is the dose for fresh frozen plasma?
6 to 10 ml/kg
What is within fresh frozen plasma?
All clotting factors
What is the shelf life of fresh frozen plasma?
Normal freezer = 3 months
-30 = 1 year
What is cyroprecipitate?
White precipitate forms after thawing fresh plasma
What is contained within cryoprecipitate?
vWF + clotting factors 13 + 8
What is a clinical disease that cyroprecipitate is best for?
von willebrand's disease
What is the dose for cryoprecipitate?
1 unit per 10 kg BW
What are the indications for a platelet transfusion?
Severe thrombocytopenia + thrombopathia
Why are many units of platelets needed?
Rapidly destroyed by IMTP + DIC
What is the dose for platelet transfusion?
1 unit per 10 kg BW
What is oxyglobin?
Ultrapurified, polymerized hemoglobin of bovine origin in LRS
What does giving oxyglobin do?
Increase oxygen carrying capacity of blood
Delivers more oxygen to damaged tissues
What is the max dose of oxyglobin?
What is a blood type?
RBC alloantigen, usually to membrane glycolipid
How many blood types do dogs have?
What are the strongest dog blood types immunologically?
1.1 + 1.2
What does it mean to be a canine universal donor?
Negative for DEA 1.1 + 1.2 + 7
What are the feline blood types?
A + B + AB
What is the dominant feline blood type?
What donors can be allowed for a cat with AB?
A + AB
Why are transfusions so dangerous in cats?
Naturally occurring alloantibodies to Type A or B cells
Blood typing is a must before a transfusion
What is the most common feline blood type in the US?
What is the equine universal donor?
There is none
How many blood types do horses have?
What are the most immunogenic horse blood types?
Aa + Qa
What are the best breeds of horses for being a blood donor?
-- or --
Quarter horse geldings
Why should mares be avoided with blood transfusions?
Can develope blood type alloantibodies during pregnancy
How many blood types do cattle have?
11 blood types
What is J antigen? What animals is it in?
Cow + Goat
Lipid found in body fluid and is absorbed onto erythrocytes
Do newborn calves have J antigen?
No, get it around 6 months of age
How many blood types do sheep have?
How many blood types do goats have?
How much must a dog weight to be a donor?
What are dog blood donors screened for?
What breed of dog is the best donor? Why?
High hematocrits + Easy to get to jugular
What is the age range for dog donors?
1 to 10 years old
What is the weight requirement of a cat to be a blood donor?
over 5 kg
What are cat blood donors screened for?
What workups are done routinely on both dog and cat blood donors?
Complete PE each donation
CBC/chem + fecal yearly
Vaccinated on schedule
Heartworm testing + treatment
How is blood donated from dogs?
No sedation - Blood bag (gravity flow)
How is blood donated from cats?
Sedation (AVOID ACE)
- may affect platelet function
Use peripheral vein
What is the donation limit for both a cat and a dog?
only once in a 3 week time period
What is a storage lesion?
Adverse biochemical changes in stored RBCS
Decreased: ATP - pH - 2,3-DPG
Increased: Lactic acid
What is the preservative put into stored blood?
How long can whole blood be stored with CPDA?
Why can't heparin be used with whole blood?
How long does Packed RBC's last?
21 days with CPDA-1
How long does fresh frozen plasma last?
What two tests can be done for cross matching?
Hemolysis + Agglutination
Term: Major crossmatch
Alloab's in recipent's plasma against donor
Term: Minor crossmatch
Alloab's in donor's plasma against recipent
Who must have typing and crossmatching before a transfusion?
What are the big four DO NOTS in transfusions?
Add any medications
use calicum-containing solutions
Use glass containers
What does calcium solutions do to blood?
What happens with the use of hyper/hypotonic solutions during a transfusion?
Why can glass containers be used in blood transfusions?
Activates platelets + clotting factors
Decreases ATP + 2,3-DPG
Increases risk for air embolism
What are the two ways which transfusions can occur?
-- or --
When would an intraosseous transfusion be done?
-- or --
How should the transfusion be started?
If massive hemorrhage is occurring give blood as fast as possible
0.25ml/kg for first 30 min w/ TPR every 5 to 10
If there is no signs of reaction what is the next step in the transfusion process?
Increase hourly rate to whatever it will take to give the unit in four hours
TPR every 30 min
What is the signs of volume overload?
Tachypneic + Dyspneic + Tachycardic
Fluid from the nose
What is the dosing for Plasma/
4 to 6 ml/min
What are the tests done post-transfussion?
What is an acute immunologic transfusion reaction?
Acute hemolytic reaction
What is a delayed immunologic transfussion reaction?
What is transfusion associated fever?
increase in 1 degree F from pre-transfusion temp
What happens if a transfusion reaction occurs?
Maintain venous access
Short acting glucocorticoids + Diphenhydramine + Oxygen
What are the contraindications for a blood transfusion?
Unable to cross match a cat
Chronic severe anemia
What is the protocal for an animal with cardiopulmonary disease that needs a transfusion?
Dont go over the rate of 4 ml/kg/hr
pre-med with diuretic
When are clinical signs of post-operative hemorrhage finally visiable?
25 to 30% blood volume loos
What are the signs of post-operative hemorrhage?
What are complications with the patient that can impede in coagulation?
What is the most common coagulopathy in dogs?
Von Willebrand's disease
What is the highest occurance, what breed?
What is von willenbrand factors function?
Plasma glycoprotein needed for normal platelet adhension to sub-endothelium
What does vWF carry?
What happens when there is a def. in vWF?
Defective platelet adhesion + Aggregation
What type of genetic mutation is vWF disease?
Describe: vWF Type 1
Reduced concentrations of vWF
Describe: vWF Type 2
Loss of high molecular weight vWF multimers
Describe: vWF Type 3
Complete absence of vWF, most severe
Which vWF disease type is most common?
What is the definitive diagnosis for vWF disesase?
Determination of vWF via ELISA
What is the treatment for vWF disease?
levels will remain elevated for 4 hours
What is DIC?
Disseminated intravascular coagulation
Systemic activation of coagulation pathway
What is seen with DIC within the body?
Compromised organ perfusion
Thrombosis + Hemorrhage
What is causing the symtoms seen in DIC?
Widespread microvascular thrombosis
Exhaustion of platelets and coagulation factors
What is the mortality rate of DIC in cats?
What is the mortality rate of DIC in dogs?
50 to 77%
What are the two main causes of DIC?
-- and --
What are infectious possibilities for DIC?
Bacterial + Viral + Protozoal + Fungal
What are the most common causes of DIC in dogs?
-- and --
What is the clinical signs of DIC?
VARY - from organ failure to hemorrhage
Which, organ failure or hemorrhage, is the most common presentation of DIC?
What are the common signs of organ dysfunction?
What gold standard test for DIC?
None, no absolute diagnostic existis
How do you diagnosis a dog with DIC?
Underlying condition with 3 of the following:
Prolonged PT +/- PTT
What is the management protocol for DIC?
Aggressive and early
Support organs susceptible to ischemia
Treat underlying condition
Remove ischemic/necrotic tissue
What organs are most sensitive to ischemia?
Kidneys + Lungs + GI
What are the six componetnts to ICU therapy of DIC?
What occurs with rodenticide toxicity?
Block vitamin K metabolism = inability to produce dependent clotting factors
What are the vitamin k dependent clotting factors?
2 - 7 - 9 - 10
What are the two agent categories that can cause rodentacide posioning?
First generation - Warfarin
Second generation - Brodifacoum
How do first generation rodentacides work?
Need to intake several dose over several days to be toxis
How do second generation rodentacides work>
lethal after first ingestion
What are the two forms of primary hemostasis?
-- and --
What can cause thrombocutopenia?
Decreased production (Drug, viral, radiation)
Increased destruction (IMTP)
What can cause thrombopathia?
Acquired: Drugs - hepatic disease + Snake venom + DIC
What is seen generally with primary hemostasis disorders?
Decreased platelet numbers or desfunction
Ecchymosis + Spontaneous bleeding
What is seen generally with secondary hemostasis disorders?
Low concentration of coagulation factors
Hematomas + Spontaneous belleding into sub-q
What is different about acquired disorders?
Affect primary and secondary
What are examples of acquired secondary hemostatic disease?
Vitamin K def.
What are examples of Congenital secondary hemostatic diseases?
What breed of dog gets hemophila A?
What breed of dog gets vWF disease?
Decreased platelet number
What are diagnostic tests for coagulopathies?
Buccal bleeding time
Artifact, falsely low platelet count
Platelet aggregation or clumping
What is buccal mucosal bleeding time?
Duration of hemorrhage resulting from small standardized injury
What is the normal bleeding time for a dog?
1.7 to 4.2 minutes
What is the normal bleeding time for a cat?
1.4 to 2.4
What does the buccal mucosal bleeding time tell you?
Relfects in vivo PRIMARY hemostatsis
Prolongation = defect in intrinsic +/- common pathway
Prolongation = Defect in extrinsic +/- commmon pathway
Activated clotting time
Whole blood in tube with clay --> acitvates F8
Time till first clot
What is a normal ACT for dog?
What is a normal ACT for cat?
What is the importance of fibrinogen?
End point of all assays - PT + pTT + ACT
What is considered severely decreased fibrinogen?
What is normal fibrinogen?
200 to 300
What is fibrinogen? (class of molecule)
Acute phase protein
What is occurring if there is an increased level of fibrinogen?
What are FDPs?
Fibrinogen degradation products
Plasmin lysiss fibrinogen + fribin + cross-linked fibrin
What does FDP indicate?
What does elevated concentrations mean?
What is occurring symptomatically with increased FDP?
inhibited clotting + induced platelet dysfunction = bleeding
What is an elevated FDP suggestive of?
DIC + Neoplasia + Sepsis + Heatstroke + GDV + SIRS + IMHA
What is a D-dimer indicative of?
Acitvation of thrombin and plasmin
What is D-dimber an indicator for?
DIC + Thromboembolism in dogs