Tranfusion

Question 1

Universal donor

Answer 1

• can be safely administered to all blood types
• O

Question 2

Universal acceptor

Answer 2

• blood type that can safely receive a transfusion of all blood types
• AB

Question 3

Type

Answer 3

• Tests for ABO & Rh-D antigens
• 5 minutes
• Recipient blood mixed w/ anti-A, B, & Rh-D

Question 4

Screen

Answer 4

• 45 min
• Recipient plasma mixed w/ commercially prepared O RBCs that contain known antigens

Question 5

Crossmatch

Answer 5

• Compatibility b/t recipient plasma & actual blood unit to be transfused
• 45 min

Question 6

Emergency transfusion of PRBCs

Answer 6

1. Type-specific partially crossmatched blood
2. Type-specific uncrossmatched blood
3. Type O negative uncrossmatched blood

(most to least favorable)

Question 7

Which blood product contains the highest concentration of fibrinogen?

Answer 7

Cryo

Question 8

Whole blood contains:

Answer 8

RBCs, WBCs, Plasma, PLT debris, Fibrinogen

Question 9

FFP contains:

Answer 9

All coag factors, fibrinogen, plasma proteins

Question 10

Cyro contains:

Answer 10

Fibrinogen, factor 8, factor 13, vWF

Question 11

Pt w/ CAD should be transfused when HCT <

Answer 11

28-30%

Question 12

EBV premie

Answer 12

90-100 ml/kg

Question 13

full term neonate

Answer 13

80-90 ml/kg

Question 14

infant

Answer 14

75-80 ml/kg

Question 15

school age chid EBV

Answer 15

70 ml/kg

Question 16

adult EBV

Answer 16

70 ml/kg

Question 17

1 pack PRBCs contains ~ ______ml w/ Hct of ____

Answer 17

300 ml, 70%

Question 18

Transfusion of 1 u PRBC raises Hgb & Hct by

Answer 18

• Hgb increases by 1 g/dL
• Hct increases by 2-3%

Question 19

Additives in PRBC

Answer 19

• citrate = anticoagulant, inhibits ca+
• phosphate = buffer, combats acidosis
• dextrose = substrate for glycolysis
• adenine = helps RBC re-synthesize ATP

Question 20

Most to least common infection complication from transfusion

Answer 20

1. Cytomegalovirus
2. Hepatitis B
3. Hepatitis C
4. HIV

Question 21

Acute hemolytic reaction

Answer 21

S/S
- hemoglobinuria
- hypotension
- bleeding
- fever
- chills
- CP
- dyspnea
- nausea
- flushing

• Acute tubular necrosis
• DIC
• HD instability

Tx:
- stop transfusion
- Maintain UOP > 75-100 ml/hr
- alkalinize urine w/ NaHCO3
- check plt, pt, fibrinogen

Question 22

Transfusion-associated acute lung injury

Answer 22

• non-cardiogenic pulm edema
• high risk = *critically ill, sepsis, burns, post CPB
• caused by human leukocyte antigens & neutrophil antibodies in donor plasma (FFP & PLT contain highest conc)
• donor groups highest risk = *multiparous women, hx transfusion, hx organ transplant
• Dx = onset < 6 hr, bilat infiltrates, SpO2 < 90% RA
• MGMT = PEEP, low Vt

Question 23

Transfusion-associated circulatory overload

Answer 23

• volume overload
• S/S = pulm edema, hypervolemia, LV dysfx, mitral regurg, increased PAOP, increased BNP
• supportive tx

Question 24

Massive transfusion associated w/

Answer 24

• alkalosis
• hypothermia
• hyperglycemia
• hypocalcemia
• hyperkalemia

Question 25

Trauma lethal triad

Answer 25

• acidosis
• hypothermia
• coagulopathy

Question 26

Intraop blood salvage is typically used during

Answer 26

cardiac, major vascular, trauma, liver transplant, ortho surgeries when EBL expected to be > 1000 ml or 20% of EBV

• also jehovahs witness

Question 27

contraindications intraop blood salvage

Answer 27

• sickle cell
• thalassema
• topical drugs in sterile field = betadine, chlorhexidine, abx
• infected surgical site
• oncologic procedures