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Blood Transfusion Flashcards

(58 cards)

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1
Q

Blood contains

A

RBC, WBC, and platelets suspended in plasma

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2
Q

Plasma

A

contains proteins such as albumin, globulin, and fibrinogen

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3
Q

Fractionation of blood

A

process by which the blood is separated into compartments

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4
Q

Changes in banked blood

A 
depletion of 2,3 DPG
acidosis
altered RBC morphology
hyperkalemia
absence of viable platelets 
absence of facots 5 and 8 (clotting factors)
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5
Q

blood is how many times more viscous than H2O

A

3x due to RNC conc.

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6
Q

increase in Hct btw 60-70% =

A

10 fold increase in viscosity

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7
Q

changes in P50 and Sa O2

A

dont alter viscosity

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8
Q

1 unit whole blood or RBC will raise Hgb

A

1g/dL

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9
Q

Transfusion indicated when

A

Hgb 10 - rarely indicated

btw 6-10 look at other factors

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10
Q

antigens

A
  • in RBC membrane
  • determine blood type
  • Specific RBC antigens are inherited and used for ABO and RH compatibility
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11
Q

Antibodies

A
  • may occur naturally or in response to sensitization

- found in serum

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12
Q

Rh positive

A

has the D antigen

- in cell membrane

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13
Q

Universal recipient

A

AB

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14
Q

Universal donor

A

O

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15
Q

ABO/Rh typing

A

most important test.

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16
Q

Type and screen

A

recipient and donor blood is typed and screened for major antibodies
- 99.94% reliable

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17
Q

type and crossmatch

A

a trial transfusion

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18
Q

blood compatibility

- Type A

A
  • antigen on RBC - A
  • antibodies in serum- Anti B
  • blood group compatibility- A, O
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19
Q

blood compatibility

- TYpe B

A
  • antigen on RBC - B
  • antibodies in serum- Anti A
  • blood group compatibility- B. O
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20
Q

blood compatibility

- Type AB

A
  • antigen on RBC - A and B
  • antibodies in serum- none
  • blood group compatibility- AB, A, B, O
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21
Q

blood compatibility

- Type O

A
  • antigen on RBC - none
  • antibodies in serum- Anti A and Anti B
  • blood group compatibility- O
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22
Q

blood compatibility

- Rh positive

A
  • antigen on RBC - D
  • antibodies in serum- none
  • blood group compatibility- Rh positive and Rh negative
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23
Q

blood compatibility

- Rh negative

A
  • antigen on RBC - none
  • antibodies in serum- Anti D if sensitized
  • blood group compatibility- Rh negative
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24
Q

MTP

Study These Flashcards
A

replacement of estimated blood volume in 24 hours, 50% in 3 hours or 10 units of blood

25
problems with MTP
- dilutional coagulopathy - most common - dilutional thrombocytopenia - citrate intoxification
26
most commonly used blood preservative/ anticoagulant?
citrate - binds to Ca - phosphate - buffer - dextrose - energy source - adenine - precursor for ATP
27
FFP indicated for reversal of.
warfarin
28
Cryo
contains factor 8, fibrinogen, fibrinonectin, von willebrands factor and factor 13 - indicated with hemophilia A
29
Cryo is derived from
a fraction of plasma that precipitates when FFP is thawed at 4 degrees C
30
All blood should be administered
through micron filter. changed Q2-4 units | - 170 micron filter allows platelets to pass.
31
Microaggregate filter
have 40 micron pore and will remove platelets, small aggregates and fibrin strands
32
Microaggregates of platelets and leukocytes
accumulate in whole blood after 3-5 days storage.
33
RBC reconstituted with
NS - No Calcium to cause coagulation
34
COmplications of transfusion
- procedural or admin error - transfusion related acute lung injury (TRALI) - Immuno- suppression (TRIM) - bacterial contamination - plt store at room temp - viral infection
35
TRALI
leading cause of morbidity and mortaility - occurs within 6 hours of transfusion - Antibodies nad white cells cause capillary membrane to leak into alveoli
36
TRIM
ppl have increased risk of infection and CA. WBC in donor causes immune suppression - decrease by washing an filtering. Leukocyte reduced.
37
Viral infections
look for antibodies, blood may be infectious but no antibodies formed yet. made in 8-11 days
38
Alternatives to homologous blood transfusion
- autologous - blood salvage and reinfusion - designated donor - acute normovolemic hemodilution
39
autologous
take blood from pt preop, store and have for surgery. - can have clerigical error and get wrong blood - contaminated while stored
40
blood salvage and reinfusion
cell saver - filter blood platelets and proteins and pt gets RBC back
41
Designated donor
not common | - friend or family donates, no advantage blood can still be contaminated
42
- acute normovolemic hemodilution
- withdrawl of blood immediately before or after induction with volume replacement - HCt maintained 21-25% - blood can remain at room temp for 6 hours before re-infusion - advantage- includes no biochemical changes associated with storage - considered in pts expected to lose > 2units
43
Advantages of ANH
- no transmission of disease - no transfusion reaction - avoidance of immunomodulatory effects - preservation of platelet function - avoidance of hypothermia - potential for improved perfusion due to low HCT - said to be simpler, less risk of bacteremia than pre donation
44
ANH is contraindicated in...
- anemia - poor renal function - CAD - Carotid disease - pulmonary disease - liver disease - poor vascular access
45
ANH main complications
MI and cerebral hypoxia
46
estimating blood loss
- volume in suction minus irrigation - volume on drapes - sponges - observed volume on floor
47
Blood loss | 4x4 sponges
10cc blood if fully soaked
48
Blood loss | large laparotomy sponges
100-150cc blood if fully soaked
49
blood volume =
70ml/kg in adults
50
calculation of MABL
( Hct start - Hct allowed) x BV | divided by HCt start
51
Blood volume replacements | crystalloids
3cc/1cc EBL
52
Blood volume replacements | colloid
1cc/1cc EBL
53
Blood volume replacements | whole blood
1cc/1cc EBL
54
Blood volume replacements | PRBC
0.5cc/1cc EBL
55
Whole blood
good for OB hemorrhage
56
2 stages resuscitation and treatment
- resuscitation, transfuse per clinical signs | - treatment- DIC, tranfuse per lab parameters
57
Supportive measures
- bair hugger | - correct metabolic acidosis
58
Recombinant activated factor VII
approved for DIC - dangerous but potentially life saving - massive thrombotic event could happen and kill pt

Blood Transfusion (1 decks)

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