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2025 Exam Block 4 > Exam 3: Lecture 22 - Blood loss and transfusions > Flashcards

Exam 3: Lecture 22 - Blood loss and transfusions Flashcards

(65 cards)

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1
Q

How do we calculate blood volume in mammalian species?

A

5-8% of total body weight is used to approximate blood volume

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2
Q

Which domestic species has the lowest blood volume (in ml/kg)?

A

Cats (47-66 ml/kg)

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3
Q

What is the total blood volume in canines?

A

86 (79-90 ml/kg)

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4
Q

How do we estimate blood loss during surgery?

A

-Cotton tipped applicator ~0.2 mL
-1 mL of blood = 1 gram of weight
-Don’t forget to check suction bottle, drapes, floor…. and talk to your surgeon!

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5
Q

A 4x4 inch, 12-ply woven sponge can absorb how much blood?

A

-Between 5 and 12.5 mL of blood

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6
Q

A 4x4 inch, 4-ply nonwoven sponge absorbs how much blood?

A

-Between 10-18.3 mL of blood

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7
Q

A 12x12-inch woven laparotomy sponge moistened with sterile saline solution before use can absorb how much blood?

A

-About 50 mL of blood

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8
Q

What are the goals of blood transfusion?

A
  1. Restore oxygen-carrying capacity
    -Anemia
    -Moderate blood loss
  2. Restore blood volume after severe & acute hemorrhage (>20 mL/kg)
  3. Replace coagulation factors
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9
Q

What is the transfusion trigger?

A

-Concentration of Hb below which DO2 decreases to the point where anaerobic metabolism starts

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10
Q

What are the 2 basic reasons a transfusion may be needed?

A

-Anemia
-Coagulopathy

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11
Q

Transfusion triggers are based on

A

-PE findings & hematological values (e.g. PCV, Hb, platelet count & caogulation values)

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12
Q

What should be considered when hemoglobin concentration is below 7 grams per deciliter (hematocrit of 21%) in dogs and cats?

A

-Administering red cells to meet oxygen transport needs

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13
Q

It is best to maintain a Hct of _____ in surgical patients

A

21-25%

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14
Q

What drop in PCV is a transfusion indicated in?

A

-Acute drop to PCV < 20% = transfusion indicated

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15
Q

1 unit of blood = ____ mL

A

500 mL

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16
Q

With pRBCs, it takes approximately ____ to raise PCV by 1%

A

1 ml/kg

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17
Q

With whole blood, it takes approximately ___ to raise PCV by 1%

A

2 ml/kg

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18
Q

How fast should blood be given?

A

-Transfuse slowly for 1st 30 min., monitoring closely for any signs of transfusion reaction
-Can go higher during critical situations
-Go slower in cats, puppies & kittens
-Finish transfusion within 4 hours to prevent bacterial contamination & loss of function

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19
Q

What rate should blood be given?

A

-Whole blood or pRBCs can be given at a rate of 5-10 mL/kg/hr after initial 30 minutes of being given slowly

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20
Q

How do we administer a blood transfusion?

A

-Admin via a dedicated peripheral or jugular IVC
-Use aseptic technique

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21
Q

Can fluids and other medications be administered along with transfusion?

A

NO!! (except 0.9% NaCl)

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22
Q

Blood should be rewarmed to ____ degrees Celsius using a warm fluid bath (NOT microwave)

A

37-39 degrees C

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23
Q

The fluid administer set should be used with a

A

Filter

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24
Q

What should be avoided with transfusions?

A

-IVF pumps (ex: Heska) b/c can crush the RBCs

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25
Canines have __ major blood groups labeled as ____, but the major antigen is ____
-8 major blood groups -Labeled as DEA (dog erythrocyte antigen) 1-8 -**Major antigen is DEA 1 (only antigen tested for)**
26
Is blood typing required on 1st transfusion?
-No b/c dogs do not have naturally occurring antibodies
27
What is the best practice for blood transfusions?
-To blood type every recipient in the event a 2nd transfusion is needed a few days later & to conserve DEA negative blood for dogs that really need it
28
What are the feline blood types?
-3 main types: A, B, AB -Majority of cats in the USA are type A
29
T/F all cats must be blood typed prior to transfusion
YES!!!! Very important
30
___ cat blood type is highly prevalent in Australia & among pure pred cats (i.e. exotic breeds)
Type B
31
What type cats have natural alloantibodies that will shorten RBC life if type B blood is given?
Type A cats
32
Type ___ cats have natural isoantibodies againdt type ___ -> causes fatal reaction even if only 1 mL of type ___ blood given!
Type B against type A, fatal if type A blood given
33
Type AB cats can receive what blood?
A or B blood types (universal recipients)
34
Type AB cats account for ___ % of the cat population
1%
35
What is a **major crossmatch**?
-Performed to detect antibodies in recipient's serum that may agglutinate or lyse donor's erythrocytes -Checks compatibility of donor RBCs & recipient plasma
36
What is a minor crossmatch?
-Detects antibodies in the donor plasma directed against recipient erythrocytes -The red cells of the recipient are tested w/ plasma from the donor
37
What is the gold standard for cross-matching?
-To cross match the donor & recipient prior to each transfusion as there are blood types that have not been recognized, and there is no type system for Mik (in cats)
38
What does a fresh whole blood transfusion do, and when must it be transfused?
-Transfused within 6-8 hours of collection -Provides RBCs, WBCs, platelets, plasma, clotting factors
39
What do we typically use fresh whole blood transfusions for?
-Acute hemorrhage or life-threatening thrombocytopenia
40
What happens to fresh whole blood after 8 hours?
-It becomes stored whole blood & the platelets & coagulation factors are markedly reduced
41
What do we use packed red blood cell transfusions for?
-Indicated for anemic patients that are normovolemic & don't need coagulation factors -use "fresher" units for critically ill patients to avoid injury associated w/ prolonged storage
42
What is fresh frozen plasma (FFP)?
-Collected in citrate anticoagulant & separate plasma from whole blood within 8 hours of collection, store frozen for up to 1 year
43
When is fresh frozen plasma indicated?
-For inherited & acquired coagulopathies
44
What is the freezer life for FFP?
1 year from the draw date -FFP becomes frozen plasma (FP) after 1 year & then remains useable as FL for the next 4 years
45
Frozen plasma does not contain the factors ____
5 and 8
46
What is **Fresh plasma**?
-Centrifuged to separate plasma from whole blood, transfuse within 4-6 hours of collection (after this, it is no longer fresh)
47
What is cryoprecipitate & cryosupernatant?
-Prepared from fresh frozen plasma, stored frozen for up to 1 year -Concentrated source of labile factors VIII, XIII, vWF, and fibrinogen
48
What are the indications for cryoprecipitate & cryosupernatant?
-Hemorrhage or prophylaxis before invasive procedures in deficiency of vWF and factor VIII
49
What is platelet rich plasma?
-Plasma & platelets separated from RBCs after centrifugation (transfuse within 48 hrs of collection) -Contains platelets & plasma
50
What are the indications for platelet rich plasma?
-Hemorrhage -Prophylaxis before invasive procedure in severe thrombocytopenic or thrombocytopathic disorders
51
What are some transfusion complications?
Immediate -Immunologic -Non-immunologic Delayed -Immunologic -Non-Immunologic
52
What are immediate immunologic effects?
-**Hemolytic reactions** -**Febrile reactions** -**Allergic reactions**
53
What are **hemolytic reactions**?
-Immediate immunologic effects -Most severe but are rare & due to incompatible blood or intra-donor incompatibility in multiple transfusions
54
What is an example of a hemolytic reaction?
-Feline mismatched transfusions are ineffective & may cause life-threatening hemolytic transfusion reactions
55
What is a **febrile reaction**?
-Immediate immunologic reaction -Any increase of one degree (Celsius) or more within 1-2 hours must be considered a febrile reaction due to white cell, platelet or plasma protein antibodies
56
What should you do if you suspect a febrile reaction is occurring?
-Stop the transfusion immediately
57
What is a transfusion **allergic reaction**?
-Immediate immunologic reaction -Patient reacts to allergens in donor RBCs, platelets, granulocytes, plasma proteins - often complement - immunoglobulins
58
What are signs of a transfusion allergic reaction?
-Urticaria -dyspnea -Laryngeal edema
59
What should you do if you suspect a transfusion allergic reaction?
-Give diphenhydramine prophylaxis in patients w/ allergic tendencies, although often ineffective -Stop transfusion immediately -Epinephrine may be used for dyspnea or anaphylactic reaction
60
What are some immediate non-immunologic reactions?
-Circulatory overload -Hypothermia -Electrolyte imbalance -Citrate intoxication (hypocalcemia)
61
What are some delayed immunologic effects?
-Delayed hemolytic reaction -Graft vs. host -Post-transfusion purpura -Alloimmunization (antibody formation)
62
What are clinical signs to watch for during transfusion?
-Tachycardia -Dysrhythmias -Hypotension -Tachypnea -Dyspnea -Tremors -Emesis -Urticaria or wheals -Transient fever -Hemolysis -Hemoglobinemia -Hemoglobinuria
63
What is important to note about clinical signs to watch for during transfusion?
-General anesthesia may mask some of these signs -If in doubt, stop transfusion!
64
What is "xenotransfusions"?
-Transfusion of blood from another species
65
What are autologous transfusions?
-Administration fo blood to patient that was previously collected from that patient -Decreased risk of transfusion reaction or transmission of disease -Patient may donate blood preoperatively (or could be collected intra or postoperativey "washed" and administered back to patient)

2025 Exam Block 4 (34 decks)

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