PRBC, Platelets

Question 1

What is the volume of Packed Red Blood Cells (PRBC)?

-Breakdown

Answer 1

350 mL

• RBC (250 mL)
• Plasma (50 mL)
• AnticoagPreservative (50 mL)

Question 2

How much Iron is in 1 Unit of PRBC?

-mL of Red Cells>

Answer 2

200 mg of Iron in 1 unit PRBC

-Each mL of Red Cells contains ~1 mg of Iron

Question 3

What is the hematocrit in a unit of PRBC?

Answer 3

55-65%

Question 4

PRBC:

• Storage
• Transport

Answer 4

• 1-6 C (within 8 hours of collection)

- 1-10 C

Question 5

PRBC - Expiration:

• CPD
• CPDA
• AS+CPD

Answer 5

PRBC - Expiration:

• CPD - 21 days
• CPDA - 35 days
• AS+CPD - 42 days*

*AS must be added within 72 hours of collection; used for PRBC only

Question 6

PRBC - Expiration if opened (“spiked):

• Refrigerated
• Room Temp

Answer 6

PRBC - Expiration if opened (“spiked):

• Refrigerated - 24 hours
• Room Temp - 4 hours

Question 7

PRBC - Mandatory Quality Control:

-Random Donor - Hematocrit

Answer 7

must be <80% for all units tested

Question 8

PRBC - Mandatory Quality Control:

-Apheresis RBCs - Hemoglobin

Answer 8

must be >50 g (or 150 mL of red cell volume) in >95% of units tested

Question 9

PRBC - Storage Lesions:

• 2,3.DPG
• Potassium
• pH
• ATP
• Free Hemoglobin

Answer 9

PRBC - Storage Lesions:

• 2,3.DPG - Decreased
• Potassium (free) - Increased
• pH - Decreased (acidic)
• ATP - Decreased
• Free Hemoglobin - Increased

Question 10

Frozen RBCs:

-Must be frozen within

Answer 10

6 days if no additive solution

-before expiration date if additive solution present

Question 11

Frozen RBCs:

-Cryoprotective agent

Answer 11

40% Glycerol

Question 12

Frozen RBCs - Storage:

• Temp
• Expiration

Question 13

Frozen RBCs - Thawed:

• Wash
• Storage
• Expiration

Answer 13

• Hypotonic solution removes glycerol
• 1-6 C
• Transfused within 24 hours

Question 14

What is the expected effect of 1 unit of PRBCs?

*Pediatric dose

Answer 14

1 g/dL increase in Hemoglobin
-3% increased in Hematocrit

*Pediatric dose - 4 mL/kg

Question 15

Platelet Transfusion Indications - Bleeding patient w/ thrombocytopenia:

• Extracranial
• Intracranial

Answer 15

• <50,000 (extracranial)

- <100,000 (intracranial)

Question 16

Like Red Cells, Platelets must always be transfused through what?

Answer 16

170 um filter

Question 17

T/F: Frozen/Deglycerized Red Cells are considered to be Leukoreduced and Washed.

Answer 17

True

Question 18

Platelets:

• Storage
• Transport
• Expiration (closed)
• Expiration (open)

Answer 18

• 20-24 C w/ gentle agitation
• Transport - w/o agitation for 24 hours
• 5 days
• 4 hours after opened

Question 19

Leukoreduced apheresis platelets:
-Number of leukocytes

*NON-apheresis platelets

Answer 19

<5x10^6 leukocytes (apheresis platelets)

*<8.3x10^5 (non-apheresis platelets)

Question 20

Single Donor Derived Platelets:

• Volume
• Fibrinogen
• Minimum Platelets
• pH

Answer 20

• 50 mL
• 80 mg fibrinogen
• 5.5 x 10^10 platelets
• pH>6.2

Question 21

Pheresis Platelets:

• Volume
• Fibrinogen
• Minimum Platelets

Answer 21

• 100 mL
• 150 mg fibrinogen
• 3.0x10^11 plateles

*Pheresis platelet unit has ~6X the number of platelets in a single donor derived unit

Question 22

Platelet Transfusion Indications:

-Nonbleeding patient

Answer 22

10,000/uL

Question 23

Platelet Transfusion Indications - Bleeding patient w/ thrombocytopenia:

• Extracranial
• Intracranial

Answer 23

• <50,000 (extracranial)

- <100,000 (intracranial)

Question 24

Platelet Transfusion Indications - Surgical patient w/ thrombocytopenia:

• Nonneurosurgical
• Neurosurgial

Answer 24

• <50,000 (Nonneurosurgical)

- <100,000 (Neurosurgical)

Question 25

Platelet Transfusion Indications: | -Functional Platelet Defects (4)

Answer 25

- Glanzmann Thrombasthenia - Bernard-Soulier syndrome - Aspirin ingestion - Renal Failure* *Trial of DDAVP or cryoprecipitate is indicated first in renal failure

Question 26

Platelet Transfusion: | -Relative Contraindication (1)

Answer 26

Immune Thrombocytopenic Purpura (ITP)

Question 27

Platelet Transfusion: | -Absolute Contraindication (2)

Answer 27

- Thrombotic Thrombocytopenic Purpura (TTP) | - Heparin Induced Thrombocytopenic Purpura (HIT)

Question 28

What expected result of 1 unit of random donor platelets? | -Apheresis unit

Answer 28

Increase platelet by 5,000/uL | -30,000/uL (apheresis units)

Question 29

What is the average platelet lifespan?

Answer 29

9.5 days

Question 30

Like Red Cells, Platelets must always be transfused through what?

Answer 30

170 um filter

Question 31

Why is Rh matching recommended for platelets?

Answer 31

- Platelets do NOT bear Rh Ags; but contaminating RBCs do | - If Rh Neg female of child bearing age recieves Rh Pos Platelets, administration of RhIg should be considered.