Blood Transfusion Flashcards

(35 cards)

1
Q

what is lecuodepletion

A

removal of white blood cells from blood before transfusion

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2
Q

after lecuodepletion what happens to the blood

A

centrifuged to RBC, platelets and plasma

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3
Q

what happens to separated plasma before transfusion

A

frozen - cryoprecipitate

fractioned to from, factor concentrates, albumin, immunoglobulins

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4
Q

what is the normal amount of RBC amount tin males compared to females

A

male - 130-180 g/L

female - 115 - 165 g/L

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5
Q

what is the transfusion time of blood and what affects the speed

A

1.5-3 hours - warmer the blood the faster the transfusion

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6
Q

what are the RBC’s stored with to keep it healthy

A

electrolytes, glucose, adenine

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7
Q

how much does 1 unit of blood raise the haematocrit

A

1 unit raise Hb by 10g/L

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8
Q

which situations would you use a blood transfusion

A

significant bleeding, acute anaemia,

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9
Q

when would you want to avoid transfusion

A

patients with chronic anaemia due to iron deficiency or vitamin deficiencies

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10
Q

what is the normal blood platelet volume

A

150-450 x 10^9/ L

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11
Q

what is the storage volume and transfusion time for platelets

A

250-350 ml about 30 minutes

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12
Q

what are the two ways to collect platelets

A

pooled - 4-6 donors pooled together to from therapeutic dose

aphaeresis - blood cycled through aphaeresis machine - only platelets removed from blood and then return to donor (reduces infection risk)

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13
Q

what is the risk of platelet transfusion

A

infection risk from arm and storage pooling

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14
Q

when would you do a platelet transfusion and when should you avoid it

A

prevent and treat bleeding in patient with thrombocytopenia or platelet dysfunction

avoid with: immune/thromboctic purpura or heparin induced thrombocytopenia

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15
Q

what is good about frozen plasma and what is the therapeutic dose

A

contains all clotting factors but levels V and VIII diminished after 6 hours of thawing

12-15 MI/Kg

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16
Q

when would you give fresh frozen plasma and when would you avoid

A

significant bleeding gin patients with abnormal clotting

avoid with single factor deficiencies or to reverse warfarin

17
Q

what do you use to reverse warfarin effects

A

prothrombin complex concentrate (factor IX complex)

high conc of vit k dependant factors

18
Q

which factors are vit k dependant and can reverse warfarin

19
Q

what is cryoprecipitate and what is it used for

A

one does 6-10 units
extracted from FFP - has fibrinogen, vWF, VIII, XIII

used as source of fibrinogen in acquired coagulopathies

20
Q

what are the acute risks of transfusions

A

acute < 24 h
immunological - anaphylaxis, acute haemolytic transfusion reaction, TRALI (transfusion - related acute lung injury)

non-immunological - bacterial contamination, TACO (transfusion associated circulatory overload), FNHTR (febrile non-haemolytic transfusion reaction)

21
Q

what are the delayed risks of transfusions

A

immunological - delayed haemolytic reaction, post transfusion purpura
iron overload

22
Q

what are the most common reactions from transfusions

A

allergic

FNHTR - febrile non-haemolytic transfusion reaction

23
Q

what is FNHTR and what’s the cause

A

febrile non-haemolytic transfusion reaction
rise in temp, tachycardia, resolves after disuse

cytokines or other bio molecules

24
Q

what is TACO

A

transfusion-associated circulatory overload
acute left ventricular failure with pulmonary oedema
24h after transfusion

25
what is the most common cause of transfusion related deaths
TACO
26
what happens if there's transfusion with bacterial contaminated components
onset in 15 mins fatal 35% of the time rigours, high fever confirm with blood culture
27
what cause acute haemolytic reaction in transfusions
most often ABO mismatch - recipient has pre-formed antibodies against antigens expressed on the transfused RBC's
28
what are the signs and symptoms of acute haemolytic reaction
fever, back pain, DIC
29
describe pre-transfusion testing of patients
determination of ABO and Rh(D) - crossmatching | check if there is an agglutination
30
what causes delayed haemolytic reaction
post transfusion formation of new immune IgG antibodies against RBC other than ABO
31
what are the features and testing for delayed haemolytic reaction
fatigue, jaundice | direct anti-globin test to detect antibodies bound on RBC's - coombs test
32
what is coombs test used for
delayed haemolytic reaction
33
what are the clinical features of allergic responses to transfusion
rash, urticaria, pruritic, periorbital oedema anaphylaxis - especially with IgA and anti-IgA are at higher risk
34
what is TRALI
transfusion-related acute lung injury | immune mediated reaction due to antibodies against leucocytes causing leaky pulmonary capillaries
35
what are the features of TRALI
hypoxaemia, no evidence of volume overload