Blood Transfusions in Practice Flashcards
1
Q
What are indications for blood transfusions?
A
- red cells
- anaemia
- platelets
- thrombocytopenia
- fresh frozen plasma
- low coagulation factors
- cryoprecipitate
- low fibrinogen
2
Q
What are alternatives to blood transfusion?
A
- pre-admission clinic- reversal of anaemia
- iron/EPO
- intra-operative cell salvage (IOCS)
- requires staffing commitment
3
Q
What are indications for red cell transfusion?
A
- prevent/correct severe acute anaemia (that could cause organ damage)
- improve QoL in uncorrectable anaemia
- prepare for surgery or speed recovery
- reverse damage caused by patients own red cells (e.g. sickle cell)
4
Q
What are features of platelets?
A
- 7 day shelf life
- stored at 33˚C
- can cross blood group (but try not to)
- 1 bag = 4 units
- increments 20-40
- reactions 1/15
- bacterial sepsis 1/75,000
5
Q
What are indications for platelet transfusions?
A
- prophylactically/theraputically to stop bleeding
- dilutional thrombocytopenia (massive transfusion)
- cardiopulmonary bypass surgery
- DIC if bleeding
- abnormalities of platelet function
6
Q
What are features of fresh frozen plasma (FFP)?
A
- processed + frozen to -25˚C
- ABO group specific FFP
- pre-thawed A
7
Q
What are indications for freah frozen plasma (FFP) use?
A
- replacement of coagulation factors, due to massive haemorrhage
- DIC in presence of bleeding
- Thrombotic Thrombocytopenia Purpura (TTP)
- replacement of coagulation factor deficiencies, where factor concentration unavailable
8
Q
What are feautes of cryoprecipitate?
A
- 2 yr shelf life
- precipitate that forms by controlled thawing of FFP at 4˚C, then frozen -25C
- contains coagulation factors
- FVIII, vWF, fibrinogen, FXIII
9
Q
What are indications for cryoprecipitate use?
A
- hypofibrinogenaemia, secondary to massive transfusion > 1.5g/L
- DIC with bleeding + fibrinogen < 1g/L
- bleeding associated with thrombolytic therapy causing hypofibrinogenamia
- renal/liver failure with abnormal bleeding
- inheritied hypofibrinogenaemia if fibrinogen concentration unavailable
- fibrinogen concentration on its way
10
Q
What are signs and causes of acute transfusion reactions?
A
- pyrexia
- FNHTR
- urticaria
- mild allergic reaction
- anaphylaxis
- dyspnoea
- TACO
- TRALI
- anaphylaxis
- shock
- IBCT
- anaphylaxis
- TRALI
- TAS
11
Q
What is the treatment for acute transfusion reactions?
A
- pyrexia
- anti-pyretic
- urticartia
- antihistamine
- dyspnoea
- O2
- diuretic
- ventilation
- adrenaline
- shock
- IV adrenaline/hydrocortisone/antihistamine
- IV fluid/ITU admission
- ventilation
- antibiotics
- FFP/platelets if DIC
