Flashcards in SA Med Transfusion CSV Deck (128)
~Why do we transfuse patients?
Replace blood components
~When transfusing what are the main components of blood we use?
~What major Dz’s can be managed with transfusion therapy?
~What is the minimum PCV that most anesthesiologist want for Sx?
22% for non-elective Sx
~What percent loss of blood volume can a healthy animal tolerate with out CS?
~What is the blood volume of a dog?
~With Peracute blood loss (with in minutes up to an hour) what change will you see in HCT?
No change in HCT
~After fluid shifts (ICF/ECF) in a blood loss event what happens to HCT?
~What Dz conditions may result in a need for transfusion?
~What test can be done to determine if there is a thrombocytopathia?
~What is the #1 rule of transfusion therapy?
Give only what they need when they need it
~What is in whole blood?
All cellular & plasma components of blood
~What are they components therapy products available?
~When you give whole blood to a pt what do they get?
~What are the indications for transfusing whole blood?
Combined RBC & Plasma deficiency
~What two Dz conditions occurring together call for transfusion of whole blood?
~When is whole blood considered fresh?
Used with in 8hrs of collection
~How long can whole blood be stored?
~When is whole blood considered “stored”?
Used >8 after collection
~How is Packed Red Blood Cells processed?
450ml fresh whole blood stored in CPDA +/- optisol spun down to make 1unit = 250ml of PRBC’s
~When is transfusion with PRBC’s indicated?
~What are the 3 big clinical signs of Anemia?
~When transfusing with PRBC’s why are you choosing this product?
Restore O2 carrying capacity
~How long can PRBC’s be stored?
about 42 days in refrigerator
~What are the three types of plasma available for transfusion?
~When is Plasma considered Fresh?
Processed from 450mL of fresh whole blood and used within 6hrs of collection
~When is plasma considered FFP?
when used within 1yr of collection
~When is plasma considered just “frozen”?
When used > 1yr after collection
~How long can Plasma be frozen for after that first year?
4 additional years
~What is the max dose of plasma?
~What does FFP have in it?
All coagulation factors & other proteins
~What can you NOT treat with a plasma transfusion (any kind)?
Hypoalbunemia - cant give enough to raise albumin levels adequately with out going over max dose
~Other than how long it has been frozen what is the difference between FFP & Frozen Plasma?
Frozen Plasma lacks coagulation factor 8
~What is the life span of refrigerated Platelets?
~What are the indications of giving platelets?
Thrombocytopenia —> Hemorrhage
~What is the best way to get funcitonal platelets to a pt?
Fresh Whole Blood
~What are the other options when giving platelets?
~What is the issue with the “other” options to give platelets?
In Vitro function is either impaired or very short (hrs)
~What does Cryoprecipitate contain?
~What is one example of when you would give cryoprecipitate?
vWF/Hemophillic dog needing Sx
~What are the general indications for giving Cryoprecipitate?
Bleeding dogs w/ specific plasma protein defeciencies
~What does cryoprecipitate come from?
1 unit of Fresh Plasma spun again then frozen
~What is Cryo-poor plasma?
What is left after cryoprecipitate is made
~What is the indication for using Cryo-poor plasma?
She doesnt think there is one just use FFP if not needing specific Cryoprecipitate
~What types of Albumin are available in Vet Med?
Lyophilized canine albumin (5% & 16%)
~What are the clinical signs of low Albumin?
~What is the big risk with giving Human serum albumin to animals?
High risk of Anaphalaxis
~What are the indications for transfusing Albumin?
Raise Albumin levels in critically ill
~What other products do we have to give pt’s oncotic support?
~What is a really good indication for transfusing Albumin?
Chronically Low BP that nothing else has helped
~What is the main risk of giving any biological transfusion product?
~What options are available for transfusing Leukocytes?
Only Fresh Whole Blood due to their very short 1/2 life - generally not preformed
~What is the signalment of animals can be used for blood donors?
~What specific tests results do you need for a blood donor?
~What is the most common component of anticoagulant solutions used in blood products?
~Why is Citrate so important in anticoagulant solutions?
Citrate chelates calcium —> inhibiting calcium dependent coagulaiton
~What coagulation factor is Calcium?
~What are the two main anticoagulant solutions for blood products?
ACD - Acid-citrate- dextrose
~What does the Dextrose do in ACD/CPD?
Nutrition for RBC’s
~What does Acid/Phosphate do in ACD/CPD?
Optimizes pH for RBC survival
~What is the ratio to use for anticoagulant:blood when making blood products?
~Should you sedate your blood donors?
No just keep calm
~How should blood donors be positioned when giving blood?
Sternal or lateral recumbancy
~What type of prep is used and what vein?
Sterile prep of Jugular Vein
~What type of bag, where should the needle be & what type of procedure?
~How can you make sure you are getting exactly 450ml of whole blood in the bag?
Use a gram scale
~How many blood types of dogs are there?
More than a dozen
~Do dogs have natural alloantibodies to blood types?
~How can you identify a dog’s antigen group?
~With Dog kennel side blood typing tests what are we testing for?
(+ or -) for DEA type 1 antigens
~What is the most common blood antigen in dogs?
1.1 62% have it
~What are the other types of DEA that you would want to test for in donors?
~Which dogs most commonly have DEA types 3 & 5?
Greyhounds & Japanese breeds
~What is interesting about DEA type 7?
It is a circulating antigen and attaches to RBC instead of being integrated into cell membrane
~What is DAL?
DAL system is prevalent in Dalmations & Antibodies to DAL produce acute reactions in dogs with out it
~How do you test for DEA types other than 1?
Send out serology cannot do in house
~What are the three feline blood types?
~Do cats have naturally occurring alloantibodies what does this mean?
YES! This means you must always test donors & recipients even on their 1st transfusion
~What type of alloantibodies do cats with Type A blood have?
Weak “anti-B” antibodies - they will have a reaction if given type B blood
~What type of alloantibodies do cats with Type B blood have?
Strong “anti-A” antibodies - they can die if given type A blood
~What type of alloantibodies do cats with Type AB blood have?
None! They are universal recipients of PRBC’s (not whole blood)
~What antibody type is primarily responsible for hemagglutination reactions?
~What antibody type is primarily responsible for hemolytic reactions?
IgA or IgM
~What cat breeds all have type A blood?
~What cat breeds have the less common type B blood?
British breeds (but not all of them)
~What is Neonatal isoerythrolysis?
Kittens w/ type A or AB born to queen w/ type B —> get alloantibodies against there blood from milk —> Anti-A antibodies cause hemolysis & possibly death
~What can be done to prevent Neonatal isoerythrolysis?
Test Queen & Tom if she is B & he is A/AB then do not let kittens nurse (hand rear them)
~What are the 2 steps to confirming compatibility of blood donor/recipeint?
1. Obtain blood type
~When obtaining blood type what do you do?
Test for type
~When determining if there are circulating antibody specific for blood types not expressed by recipient RBC’s what do you do?
Major & Minor cross match test
~What are the two types of blood typing tests available cage side that give instant results?
Card style agglutination test
~What is a major crossmatch TQ?
Assesses compatibility between DONOR RBC’s & patient/recipient PLASMA/SERUM
~What is a minor crossmatch TQ?
Assesses compatibility between DONOR PLASMA/SERUM & patient/recipient RBC’s
~Does compatible cross matching rule out the possibility of an adverse transfusion reaction?
~What does cross matching determine?
~What specifically is cross matching testing for?
Natural alloantibodies (cats)
~What are you looking for in a cross match test?
Hemolysis &/or Agglutination
~What is the difference between rouleaux formation and Agglutination?
Rouleaux - RBC’s stacked like coins
~Is there a magic PCV level that automatically indicates transfusion?
No based on CS & Judgement of pt/case
~When should you transfuse Plasma?
Severe bleeding due to a factor deficiency
~When should you transfuse component replacements?
Deficit causing clinical signs
~How do you transfuse blood products?
~What is the Rate at which you should infuse blood products?
0.25-1ml/kg/hr for 1st 20 minutes
~How long can blood products sit at room temp before they must be discarded?
No more than 4 hrs
~When will acute reactions occur during transfusion?
With in the first 20 min!
~What should you monitor & what indicated a reaction during transfusion?
~How often should you monitor during transfusion?
Every 5min for the first 30 then every 15 until done
~What are two types of Autologous transfusions?
Planned self transfusion
~When would you do a planned self transfusion?
When Sx in planed a few wks in advance and you anticipate possible large hemorrhage
~When would you do an Emergency Auto transfusion & how?
Blood salvaged intra-op or from body cavity
~When will you NEVER do an emergency Auto transfusion?`
NOT neoplastic effusions (like ruptured HSA)
~What are the most common types of immunologic transfusion reactions?
~What are the less common types of immunologic transfusion reactions?
~What is an immunologic acute hemolytic transfusion reaction & CS?
~What is an immunologic acute Non-hemolytic transfusion reaction & CS?
~What is an immunologic delayed transfusion reaction & CS?
Extravascular hemolysis 2-21 days post
~What is an immunologic Purpura transfusion reaction & CS?
Thrombocytopenia 1 wk post
~What are non immunologic transfusion reaction?
~What is an Anaphylactoid non-immunologic transfusion reaction & CS?
Too rapid infusion
~What is a TACO non-immunologic transfusion reaction & what is it from?
~When is Citrate Intoxication a big risk?
After massive transfusions
~What qualifies as a massive transfusion?
Replacing the entire blood volume in 24hrs or
~When is hyperammonemia or Acidosis transfusion reactions most common?
When using older blood products
~What is treatment for transfusion reactions?
~What is Oxyglobin?
Cell free bovine derived Hg
~What is Oxyglobin used for?
Increase O2 & CO2 transport ONLY
~What are some good things about it Oxyglobin?
Significant colloidal Effect