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Immunohematology > Lecture 9: Blood Component Therapy > Flashcards

Lecture 9: Blood Component Therapy Flashcards

1
Q

When is whole blood used?

A

actively bleeding patients
lost at least 25% of their blood volume
patients requiring exchange transfusion

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2
Q

What happens when whole blood is run out?

A

reconstituted whole blood may be used
(RBCs mixed with thawed type AB FFP from a different donor)

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3
Q

When are RBCs used?

A

oncology patients undergoing chemotherapy or radiation therapy
trauma patients
surgery patients
dialysis patients
premature infants
patients with sickle cell anemia

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4
Q

How does RBC transfusion affect the patient?

A

increases the patient’s hemoglobin approximately 1 g/dl and the hematocrit by 3 %

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5
Q

When are Leukocyte-Reduced RBCs used?

A

chronically transfused patients
patients having known febrile transfusion reactions

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6
Q

When is Leukoreduction (filtration) done?

A

72 hours from collection time

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7
Q

AABB Standards for Leukocyte-Reduced RBCs

A

85% of RBCs must remain
leukocytes must be reduced to less than 5x106 WBC/unit

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8
Q

What is added to Frozen RBCs

A

frozen by adding glycerol to prevent cell hydration and the formation of ice crystals that can cause cell lysis

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9
Q

What is done for frozen RBCs to be used?

A

Thawed
Glycerol Removed by washing the RBCs with a series of saline solutions
Must be used within 24 hours

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10
Q

What are washed RBCs used for?

A

Used for patients who have a reaction to plasma proteins
Used in infant or intrauterine transfusions

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11
Q

For washed RBCs, how much RBCs are lost?

A

10-20%

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12
Q

What are Irradiated RBCs used for?

A

prevents T cells proliferation using gamma radiation

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13
Q

What do T cells cause

A

caused graft-versus-host disease, with 90% of cases being fatal

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14
Q

What are platelets used for?

A

Use to control or prevent bleeding

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15
Q

When is the need for platelets indicated?

A

Indicated in patients with chemotherapy
post-bone marrow transplant patients
patients experiencing postoperative bleeding

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16
Q

Platelet concentrates

A

Contain approximately 5.5 x 1010 platelets/unit

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17
Q

Pooled platelets

A

choose one platelet bag of those to be pooled and empty content of other bags into it

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18
Q

What is the usual platelet order?

A

6-10 units

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19
Q

Plateletpheresis

A

HLA matched patients who receive numerous platelet transfusions can develop antibodies to the class I

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20
Q

What happens when HLA antigens are not matched?

A

platelets will not last for 5 days in the patient’s circulation

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21
Q

Purpose of FFP?

A

replace coagulation factors in the patient

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22
Q

When is the need for FFP indicated?

A

Bleeding patients who require factors II, V, VII, IX, and X
Abnormal coagulation due to massive transfusion
DIC when fibrinogen is > 100 mg/dL
Antithrombin III deficiencies
Patients on anticoagulants who are bleeding or require surgery

23
Q

Thawing process for FFP

A

in water bath at 30-37oC for 30-45 minutes in watertight container
agitators are preferred because the unit thaws faster

24
Q

Cryoprecipitated Antihemophilic Factor

A

It contains factor VIII, fibrinogen, Factor XIII, and von Willebrand factor

25
Q

When is Cryoprecipitated Antihemophilic Factor used?

A

with factor XIII deficiency
as a fibrin sealant

26
Q

Pooled cryoprecipitate

A

pooled into one bag before transfusion
thawed in a similar fashion to FFP before pooling

27
Q

Fibrin glue

A

1-2 units of cryoprecipitate are mixed with thrombin and applied topically to the bleeding area

28
Q

Granulocyte transfusions are considered?

A

rare and limited to septic infants

29
Q

What is in a pheresis bag for Granulocyte Pheresis?

A

> 1.0 x 1010 granulocytes, platelets, and 20-50 ml of RBCs

30
Q

How long does it take for cells to deteriorate in Granulocyte Pheresis?

A

2 hours

31
Q

Labeling Current labeling requirements include

A

proper name
unique number
amount of blood collected
amount and type of anticoagulant
volume of component
expiration date
storage temperature
ABO/D type
reference to the “Circular of Information for the Use of Human Blood and Blood Components,”
warning regarding infectious agents
prescription requirements
donor classification
FDA license number if applicable

32
Q

What are some additional labels that are needed?

A

Irradiated components- with facility name
Autologous unit
Circular of Information for the Ue of Human Blood and Blood Components”
Pooled components: labels

33
Q

Emergency Transfusions

A

Rapid loss of blood can result in hemorrhagic shock

34
Q

Rapid blood loss symptoms

A

Hypotension, tachycardia, pallor, cyanosis, cold clammy skin, oliguria, decreased hematocrit, decreased (CVP), CNS depression, and metabolic shock

35
Q

What is are the priority of acute blood loss?

A

Replace and maintain blood volume
Make sure oxygen carrying capacity is adequate
Maintain coagulation system integrity
Correct metabolic colloid osmotic pressure

36
Q

Massive transfusion

A

Replacement if a person’s entire blood volume (approximately 10 units) within 24 hours)

37
Q

If time is not available to type the patient

A

type O, D negative blood is transfused into women of childbearing age
Type O, D positive blood is transfused into me

38
Q

What is one main difference with transfusing infants vs adults?

A

Smaller blood volume
Transfusions are given in small volumes in multiple packs

39
Q

Premature infants need transfusion to do what?

A

offset the effect of hemoglobin F in their system
Since HbF doesn’t give up O2 easily

40
Q

Iatrogenic blood loss

A

blood taken from the neonate or infant for laboratory tests
cause the neonate or infant to develop an anemia that may be severe enough to transfuse

41
Q

Why use warmer bloods on infants?

A

Neonates and infants do not tolerate hypothermia
liver’s inability to metabolite citrate anticoagulants and potassium

42
Q

Liver transplant patients require large amounts of blood products because?

A

the liver produced many coagulation factors and cholesterol for RBC membranes

43
Q

What type of transplants need ABO compatibility?

A

kidney, liver, and heart transplants

44
Q

Progenitor cell transplants

A

Derived from bone marrow or umbilical cord blood

45
Q

Wiskott–Aldrich syndrome (WAS

A

rare X-linked recessive disease

46
Q

Wiskott–Aldrich syndrome (WAS) symtpoms

A

Eczema
thrombocytopenia (low platelet count)
immune deficiency
bloody diarrhea

47
Q

Fanconi Anemia

A

the result of a genetic defect in a cluster of proteins responsible for DNA repair

48
Q

Fanconi Anemia symptoms

A

acute myelogenous leukemia (Most common)
Bone marrow failure- about 90%
60-75% have congenital defects
75% have some form of endocrine problem

49
Q

Therapeutic Hemapheresis

A

Replacement of blood from a patient to improve a patient’s health

50
Q

Oncology

A

Chemotherapy drugs kill all cells that are undergoing mitosis

51
Q

Action of chemotherapist drugs

A

Stopping DNA replication
Interfering with mRNA production

52
Q

Sickle Cell Anemia

A

abnormal hemoglobin (e.g., Hgb S) causes cells to be removed from circulation, resulting in a lowered hematocrit

53
Q

Thalassemia

A

Decreased synthesis of the alpha and beta globin chains
Hemolytic anemia results
Transfusion support necessary

54
Q

Aplastic Anemia

A

Blood transfusion support is usually needed until bone marrow transplant can occur

Immunohematology (16 decks)

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