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Anesthesia & Analgesia > Lecture 22: Blood Loss & Transfusions (Exam 3) > Flashcards

Lecture 22: Blood Loss & Transfusions (Exam 3) Flashcards

(49 cards)

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1
Q

Why is blood loss a concern

A

Absolute hypovolemia -> decreased CO & hypotension -> decreased oxygen perfusion of tissue -> dev of metabolic acidosis

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2
Q

What % of total body weight is used to approximate blood volume in mammalian species

A

5 to 8%

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3
Q

Which domesticated species has the lowest blood vomue (ml/kg)

A

Cats

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4
Q

Fill out the following:

A
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5
Q

How is blood loss estimated during sx

A
  • Cotton tipped applicator ~ 0.2 mL
  • 1 mL of blood = 1 gram of weight
  • Check the suction bottle, drapes, floor, & talk to the surgeon
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6
Q

What are the goals of transfusion

A
  • Restore oxygen-carrying capacity (anemia & moderate blood loss)
  • Restore blood volume after severe & acute hemorrhage ( > 20 mL/kg)
  • Replace coagulation factors
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7
Q

Transfusion trigger = what

A

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

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8
Q

Why are multiple factors used to determine the goals of transfusion

A

B/c it is difficult to assign an exact # @ which transfusion is implemented

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9
Q

What are the 2 basic reasons a transfusion may be needed

A
  • Anemia
  • Coagulopathy
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10
Q

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

A

Admin of RBC to meet oxygen transport

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11
Q

What PCV indicates transfusion

A

Acute drop to PCV < 20%

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12
Q

What equation is used to determine the volume of whole blood to administer to a dog? What about a cat?

A
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13
Q

approx 1 ml/kg of pRBCs is need to raise the PCV by what %

A

1%

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14
Q

How much whole blood is needed to raise the PCV by 1%

A

2ml/kg

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15
Q

How fast should blood be given

A
  • Whole & pRBCs - a rate of 5 to 10 mL/kg/hr after the initial 30 min of being given slowly
  • Start slowly (1/4 mL/kg/hr) during the first 30 min
  • Can go higher during critical situations
  • Go slower in cats, puppies, & kittens
  • Finish the transfusion w/in 4 H to prevent bacterial contamination & loss of function
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16
Q

How can transfusions be admin

A

Peripheral or jugular IVC

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17
Q

T/F: Do not admin other fluids (except 0.9% NaCl) or medications along w/ transfusion

A

True

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18
Q

To what temps should stored blood be rewarmed to

A

37 to 39 degrees C

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19
Q

How many major blood groups are found in canine

A

8 types

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20
Q

What is the major antigen & the only one tested for

21
Q

Why is blood typing not req on the first transfusion

Study These Flashcards
A

B/c dogs do not have naturally occurring antibodies

22
Q

What is the best blood typing practice

Study These Flashcards
A

Blood type every recipient in the event a 2nd transfusion is needed a few days later & to conserve DEA neg blood for dogs that really need it

23
Q

What are the blood types in cats

24
Q

T/F: Cats do not have to be typed prior to transfusions

Study These Flashcards
A

False; all cats must be typed prior to transfusions

25
What blood type are a majority of the cats in US
Type A
26
What do Type A cats have
Natural alloantibodies that will shorten RBC life if type B blood given
27
What do type B cats have
Natural isoantibodies against type A that can lead to a fatal reaction even if only 1 mL of type A blood is given
28
Which blood type in cats is considered the universal recipient
Type AB
29
Describe a major crossmatch
* Performed to detect antibodies in the recipient's serum that may agglutinate or lyse the donor's erythrocytes * Checks compatibility of donor RBCs & recipient plasma
30
What is a minor crossmatch
* Detects antibodies in the donor plasma directed against recipient erythrocytes * The red cells of the recipient are test w/ plasma from the donor
31
What is the gold standard of cross matching
To cross match the donor & recipient prior to each transfusion as there are blood types that have not been recognized & there is no type system for mik (in cats)
32
Describe fresh whole blood
* Transfused w/in 6 to 8 H of collection * Provides RBCs, WBCs, platelets, plasma, & clotting factors * Used for acute hemorrhage or life-threatening thrombocytopenia
33
What happens to fresh whole blood after 8 H
After 8 H it becomes stored whole blood & the platelets & coagulation factors are markedly reduced
34
What causes hematocrit to increase over the baseline value imm after transfusion & increase further w/in 24 H
Volume redistribution
35
Describe packed RBCs
* Indicated for anemic px that are normovolemic & don't need coagulation factors * Be sure to use "fresher" units for critically ill px to avoid injury assoc w/ prolonged storage
36
Describe fresh frozen plasma
* Collected in citrate anticoagulant & separate plasma from whole blood w/in 8 H of collection, store frozen for up to 1 Y * Indicated for inherited & acquired coagulopathies * Freezer life for FFP is 1 year from the draw data * After 1 Y it become s frozen plasma & remains useable as FP for the next 4 years * FP doesn't contain factors 5 to 8 factors
37
What is fresh plasma
Centrifuged to separate plasma form whole blood & transfused w/in 4 to 6 H of collection
38
What is cryoprecipitate & cryosupernatant
* Prepared from fresh frozen plasma stored frozen for up to 1 Y * Concentrated source of labile factors VIII, XIII, vWF, & fibrinogen
39
What are the indications of cryoprecipitate & cryosupernantant
Hemorrhage or prophylaxis before invasive procedures in deficiency of vWF & factor VIII
40
What is platelet rich plasma
* Plasma & platelets separated from RBCs after centrifugation * Contains platelets & plasma
41
What are the indications for giving platelet rich plasma
* hemorrhage * Prophylaxis before invasive procedure in severe thrombocytopenic or thrombocytopathic disorders
42
Describe hemolytic reactions
* Immediate immunologic effect * Most severe but are rare & are due to incompatible blood or intra-donor incompatibility in multi transfusions * Feline mismatched transfusions are ineffective & may cause life threatening hemolytic transfusion reactions
43
Describe febrile reactions
* Immediate immunologic reactions * Any increase of one degree (celsius) or more w/in 1 to 2 hours must be considered a febrile reaction due to white cell, platelet, or plasma protein antibodies * Stop transfusion immediately
44
Describe allergic rxns
* Immediate immunologic rxn * Px reacts to allergens in the donor blood (red cells, platelets, granulocytes, & plasma proteins like complement immunoglobulins) * Signs of urticaria, dyspnea, & laryngeal edema Give diphenhydramine prophylaxis in px w/ allergic tendencies although this is often ineffective * Stop the transfusion immed * Epinephrine may be used for dyspnea or anaphylactic rxn
45
List some immediate non-immunologic rxns
* Circulatory overload * Hypothermia * electrolyte imbalance * Citrate intoxication (hypocalcemia)
46
What are some delayed immunologic effects
* Delayed hemolytic rxn * Graft vs. host * Post transfusion purpura * Alloimmunization (antibody formation)
47
Give a list of clinical signs to watch for during a transfusion
48
What are xenotransfusions
* Transfusion of blood from another species * Done w/ canine blood in felines
49
Describe autologous tranfusions
* Admin of blood to a px that was prev collected from that px * Decreased risk of transfusion rxn or transmission of dx * Px may donate blood preop or it could be collected intra or post op, "washed", & admin back to the px

Anesthesia & Analgesia (29 decks)

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