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Y3R4 - BMS 🏥 > L8: Blood Components Transfusion > Flashcards

L8: Blood Components Transfusion Flashcards

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1
Q

what are blood components?

A
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2
Q

Content of Packed RBCs

A
  • RBCs.
  • A preservative, typically citrate-based.
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3
Q

Indications of Packed RBCs

A
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4
Q

RBC transfusion is not routinely indicated for pharmacologically treatable anemia as …..

A
  • Iron deficiency anemia.
  • Vitamin B12 or folate deficiency anemia.
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5
Q

Preparation of Packed RBCs

A
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6
Q

Adminstration of Packed RBCs

A
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7
Q

RBC Transfusion Recommendations for Hospitalized, Hemodynamically stable patients in specific clinical Situations

A
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8
Q

Rate of Production of Platlet Concentration

A

2-5 x 10^6 / sec in adults.

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9
Q

Normal range of Platlet Concentration

A
  • 150-400 x 10^9/L.
  • 150-400 x 10^6/cm3
  • 150-400 x 10^3/mm3
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9
Q

Antigens of Platlet Concentration

A
  • Strong expression of HLA class-I antigens.
  • Weak expression of ABO antigens.
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9
Q

Types of platlet concentrate

A
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10
Q

when are HLA-matched platelets Used?

A

Used in refractory patients who don’t have satisfactory respor a normal platelet transfusion.

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11
Q

what is Platelet refractoriness?

A

The repeated failure to obtain satisfactory response to platelet transfusion.

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12
Q

Temperature of Platlet Storage

A

between 20°C & 24°C

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12
Q

Storing of Platlet Storage

A

A platelet agitator…

  • Ensure viability & prevent aggregation.
  • By providing continuous gentle horizontal motion to the packs.
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13
Q

Causes of Platelet refractoriness

A
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14
Q

Shelf life of Platlet Storage

A

5 - 7 days.

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15
Q

If any gross aggregates are seen do not transfuse.

A

if any gross aggregates are seen do not transfuse.

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16
Q

Adminstation of Platlet Concentration

A
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17
Q

Indications of Platlet Concentration

A
  • TTT
  • Prophylaxis
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18
Q

Indications of Platlet Concentration as a TTT

A

Aim: A platelet count of >75 x 10’ /L

In multiple trauma & eye or CNS injury: keep platelet count >100 x 10°/L

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19
Q

Indications of Platlet Concentration as a prophylaxis

A

Platelel count Less than 10 x 10^9 /L

  • Platelet transfusion is not required routinely prior to bone marrow aspiration/biopsy, Prophylaxis in stable patients with long term bone marrow failure.

Plalelel count less tahn 20 x 10^9 / L & presence of Additional risk factors for bleeding as sepsis

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20
Q

Target platelet counts during surgery

A
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21
Q

Content of Fresh Frozen Plasma

A
  • Plasma, including all coagulation factors & plasma proteins.
  • All cellular components are removed from the transfusion product.
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22
Indications of **Fresh Frozen Plasma**
23
Adminstation of **Fresh Frozen Plasma**
24
Thawed plasma should be given within max 2 hours to avoid loss of potency of coagulation factors.
...
25
Def of **Crypercepitate Transfusion**
The small fraction of plasma that separates out (precipitates) when plasma is frozen & then thawed in the refrigerator.
26
Content of **Crypercepitate Transfusion**
- Clotting factors (Fibrinogen - Factor VIII - Factor XIII), Concentrated smaller amount of Liquid. - VWF (von Willebrand Factor).
26
Def of **Granulocyte Transfusion**
A medical procedure in which granulocytes (as neutrophil) are infused into a person's blood.
27
Indications of **Crypercepitate Transfusion**
- Replace several blood ciotting factors such as: 1. Factor VIII (Missing in patients with hemophilia A). 2. Fibrinogen (less than 0.8 -1 g/l). - Replace Von Willebrand factor (needed to help platelets work).
28
Collection of **Granulocyte Transfusion**
* Collected by apheresis.
29
Transfusion of **Granulocyte Transfusion**
Granulocyte must be transfused as soon as possible after collection, As their function deteriorates rapidly with storage.
30
Indications of **Granulocyte Transfusion**
31
**Criteria of Donor Selection in Blood Transfusion**
- Wellbeing - Age - Whole blood volume collected & weight of donor - Donation Interval - BP - Pulse - Temperature - Respiration - Hemoglobin
32
Wellbeing **Criteria of Donor Selection in Blood Transfusion**
The donor shall be: - In Good health - Mentally alert - Physically fit. - No findings suggestive of: - End organ damage or secondary. - Complication (cardiac, renal, eye or vascular). - History of feeling giddiness, fainting made out during history & examination.
33
Age **Criteria of Donor Selection in Blood Transfusion**
- Minimum age: 18 years. - Maximum age: 65 years.
34
Whole blood volume collected & Weight of donor **Criteria of Donor Selection in Blood Transfusion**
350 ml → 45 kg. 450 ml → 55 or more kg.
34
BP **Criteria of Donor Selection in Blood Transfusion**
Systolic 100-140 mmHg Diastolic 60-90 mmHg.
35
Donation interval **Criteria of Donor Selection in Blood Transfusion**
For whole blood donation: - For males: Once in 3 months - For females: Once in 4 months
36
Pulse **Criteria of Donor Selection in Blood Transfusion**
- Rate: 60-100/min. - Rhythm: regular.
37
Temperature **Criteria of Donor Selection in Blood Transfusion**
Afebrile
38
Respiration **Criteria of Donor Selection in Blood Transfusion**
Free from respiratory diseases
39
...
...
39
Hemoglobin **Criteria of Donor Selection in Blood Transfusion**
Moran than or equal 12.5 gm/dl
40
Mind Map of adverse transfusion reactions
41
Infectious adverse effects
42
what are acute transfusion reactions?
- Febrile Non-Hemolytic Transfusion Reaction - Allergic (urticarial) reactions - Anaphylactoid / anaphylactic - Acute hemolytic transfusion reaction (AHTR) - Transfusion related acute lung injury (TRALI)
43
Frequency of **Febrile Non-Hemolytic Transfusion Reaction**
0.1 - 1.0 %
44
Mechanism of **Febrile Non-Hemolytic Transfusion Reaction**
45
Clinical features of **Febrile Non-Hemolytic Transfusion Reaction**
Increased Temperature more than or equal 1C (2°F) within 2 hours of start of transfusion with no other explanation for fever
46
Managment of **Febrile Non-Hemolytic Transfusion Reaction**
- Risk minimized with leukocyte-reduced products. - Acetaminophen premedication if reactions are recurrent.
47
Frequency of **Allergic (urticarial) reactions**
1-3%
48
Mechanism of **Allergic (urticarial) reactions**
49
Clinical features of Allergic (urticarial) reactions
- Urticaria. - Flushing. - Pruritus. - Mild wheezing.
50
Managment of **Allergic (urticarial) reactions**
- Pause transfusion. - Administer antihistamines. - Resume transfusion if reaction resolves, but still - report reaction to blood bank.
51
Frequency of **Anaphylactoid / anaphylactic Reactions**
1: 20,000 - 50,000
52
Mechnism of **Anaphylactoid / anaphylactic Reactions**
53
Clinical Features of **Anaphylactoid / anaphylactic Reactions**
- Hypotension. - Bronchospasm. - Anx - Urticaria. - Angioedema. **Rule out hemolysis.**
54
Managment of **Anaphylactoid / anaphylactic Reactions**
- Stop transfusion. - IV colloids: to maintain Blood pressur circulatory volume. - Antihistamines & corticosteroids. - In severe cases: - Administer epinephrine 1:1000 (0.2-0.
55
Cause of **Acute hemolytic transfusion reaction (AHTR)**
- Preformed antibodies to incompatible product (1: 76,000). - ABO incompatibility (1: 40,000). - Sometimes fatal (1: 1.8 x 105).
56
Frequency of **Acute hemolytic transfusion reaction (AHTR)**
- Preformed antibodies to incompatible product (1: 76,000). - ABO incompatibility (1: 40,000). - Sometimes fatal (1: 1.8 x 105).
57
Clinical Features in Acute hemolytic transfusion reaction (AHTR)
- Fever. - Renal failure. - Chills. - Back pain. - Hypotension. - DIC (Disseminated Intravascular Coagulation). - Hemoglobinuria.
58
Managment of Acute hemolytic transfusion reaction (AHTR)
- Keep IV open with normal saline. - Keep Urine output >1 mL/kg/hour. - Vasopressors. "If needed" - Treat DIC.
59
Frequency of **Transfusion related acute lung injury (TRALI)**
- 1: 10,000 "uncommon syndrome"
60
Cause of **Transfusion related acute lung injury (TRALI)**
61
Mechanism of **Transfusion related acute lung injury (TRALI)**
62
Clinical Features in Transfusion related acute lung injury (TRALI)
63
managment of Transfusion related acute lung injury (TRALI)
- No specific treatment exists for this syndrome, Management of TRALI is supportive. - Corticosteroids have been used for ALI/ARDS. "But the results are inconsistent" - For hypoxemia: Providing oxygen supplementation The central management approach"
64
What are Delayed Transfusion Reactions?
- Delayed HTR - Transfusion Associated Graft Versus Host Disease (TA GVHD)
65
Mechanism of **Delayed HTR**
66
Clinical Features of **Delayed HTR**
Include: * Fever * Jaundice. * Falling hemoglobin.
67
Managment of **Delayed HTR**
Transfuse PRN with compatible RBC. **PRN: Pro Re Nata means as needed**
68
Frequency of **Transfusion Associated Graft Versus Host Disease (TA GVHD**
Rare
69
Mechanism of **Transfusion Associated Graft Versus Host Disease (TA GVHD**
- Transfusion of viable T-cells presents in blood products. - This cells not rejected by the transfusion recipient because of: 1. Recipient immunodeficiency. Or 2. A common HLA haplotype between blood donor & recipien
70
Risk Factors of **Transfusion Associated Graft Versus Host Disease (TA GVHD**
- Volume & age of blood transfused, As this determine the number of viable T-cells. - HLA haplotype sharing between donor & recipient. - Depressed immune function.
71
Time of **Transfusion Associated Graft Versus Host Disease (TA GVHD**
presenting 1-4 weeks after transfusion.
72
CP of **Transfusion Associated Graft Versus Host Disease (TA GVHD**
* Maculopapular rash. * Hepatitis. * Diarrhea. * Pancytopenia.
73
Complications of **Transfusion Associated Graft Versus Host Disease (TA GVHD**
Almost always fatal with fatal outcome in mos patients.
74
Managment of Transfusion Associated Graft Versus Host Disease (TA GVHD)
Prevented by irradiating blood products.
75
Definition of **Massive Blood Transfusion**
- Acute administration of > 1.5 times the patient estimated blood volume. - The replacement of the patient total blood volume by stored blood bank in less than 24
76
Complications of **Massive Blood Transfusion**
- Coagulopathy - Citrate toxicity - Hypothermia - Acid Base balance - Increased Serum potassium
77
Incidence of Transfusion-Related Coagulopathy
Common with massive transfusion.
78
Cause of Transfusion-Related Coagulopathy
79
Transfusion-Related Citrate toxicity
80
TTT of Transfusion-Related Citrate toxicity
Intravenous calcium administration. **But identification of the problem requires a high index of suspicion.**
81
Transfusion-Related Hypothermia
- Should not occur on a regular basis. - Massive transfusion is an absolute indication for the warming of all blood & fluid to body temperature as it is being given.
82
acid-base Balance in Massive Blood Transfusion
83
Serum potassium in massive blood transfusion

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