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80 Cards in this Set
- Front
- Back
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Are the growing numbers of blood transfusions because we're being more liberal in doing them, or patients need them more?
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Patients
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How old do you have to be to donate blood?
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17
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How many weeks do you have to wait between blood donations?
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8
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How much blood is taken in a whole blood donation?
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~500 mL
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When were the first TA-AIDS cases reported, and what was the response?
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1982; high risk donor deferrals were initiated.
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Is there a zero % rate of HIV transmission now that HIV has been discovered and Anti-HIV screening is done?
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no
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Are blood donors compensated for donating?
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no
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What do you get from a whole blood donation?
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-Red cells in additive solution
-Plasma -platelets are thrown out |
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What are 3 things done in Blood processing?
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-ABO/Rh typing
-Antibody screening -Infectious disease testing |
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Why is CMV testing especially important?
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Because CMV pos blood can still be transfused, just not to immunocompromised patients that are CMV neg
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What 7 diseases do we screen blood products for?
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-Hep B, Hep C
-HIV -West nile virus -Syphilis -HTLV -Chagas disease |
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What is CPDA?
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Citrate
Phosphate Dextrose Adenine |
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What is the shelf life of blood with CPDA1?
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35 days
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What are the requirements for whether a blood product can be used?
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70% of cells must remain viable at unit outdate or 24 hours after transfusion
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Even if cells remain viable, what changes might we see that decrease the utility of a blood transfusion?
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Decreased vasodilatory abilities and Nitric oxide metabolism
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Are the growing numbers of blood transfusions because we're being more liberal in doing them, or patients need them more?
|
Patients
|
|
|
How old do you have to be to donate blood?
|
17
|
|
|
How many weeks do you have to wait between blood donations?
|
8
|
|
|
How much blood is taken in a whole blood donation?
|
~500 mL
|
|
|
When were the first TA-AIDS cases reported, and what was the response?
|
1982; high risk donor deferrals were initiated.
|
|
|
Is there a zero % rate of HIV transmission now that HIV has been discovered and Anti-HIV screening is done?
|
no
|
|
|
Are blood donors compensated for donating?
|
no
|
|
|
What do you get from a whole blood donation?
|
-Red cells in additive solution
-Plasma -platelets are thrown out |
|
|
What are 3 things done in Blood processing?
|
-ABO/Rh typing
-Antibody screening -Infectious disease testing |
|
|
Why is CMV testing especially important?
|
Because CMV pos blood can still be transfused, just not to immunocompromised patients that are CMV neg
|
|
|
What diseases do we screen blood products for?
|
-Hep B, Hep C
-HIV -West nile virus -Syphilis -HTLV -Chagas disease |
|
|
What is CPDA?
|
Citrate
Phosphate Dextrose Adenine |
|
|
What is the shelf life of blood with CPDA1?
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35 days
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|
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What are the requirements for whether a blood product can be used?
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70% of cells must remain viable at unit outdate or 24 hours after transfusion
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Even if cells remain viable, what changes might we see that decrease the utility of a blood transfusion?
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Decreased vasodilatory abilities and Nitric oxide metabolism
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What are effects of storage of blood products?
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Decreased 2,3 DPG
Decreased intracellular K+ Platelets/WBCs nonviable Decreased labile coag Fxs Increased cytokines Bacterial contamination |
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What are the labile coag factors?
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Fx 5 and 8
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What are we mostly concerned with regarding cytokine concentrations increasing and bacterial contamination? Why?
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Platelets - because they are kept at room temp
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Where does the cytokine concentration increase occur?
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Outside the cells, as the intracellular concentration is released.
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What is the main blood group system we're worried about in transfusion reactions?
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ABO
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Why do ABO blood groups cause the worst Transfusion reactions?
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-Their antibodies occur naturally
-They activate complement -They're very potent |
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What is the universal donor when talking about packed RBCs?
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Type O
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What is the universal recipient when talking about packed RBCs?
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Type AB - can give cells with A, B, or A/B
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Which Rh antigen is most responsible for HDN? Why?
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D; it is the most immunogenic
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Are the Rh antibodies naturally occuring?
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no
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What does the DAT detect?
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Antibodies that have coated the ANTIGENS ON RBCs in the body
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What are 4 causes of a pos DAT?
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-AIHA
-DIHA -Hemolytic transfusion reaction -HDN |
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What does the IAT detect?
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ANTIBODIES in the patient's serum
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What are the 3 situations that use the IAT?
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-Antibody screen
-Red cell TYPING -Compatibility testing |
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How do you do the DAT?
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By washing/isolating the patient's RBCs, resuspending, and adding Coomb's reagent to detect hemolysis
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What will a pos coomb's test show?
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Agglutination - no hemolysis
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How do you do an IAT?
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By removing the RBCs from plasma, adding known phenotype RBCs to the plasma, and then using Coombs to see if there was a reaction.
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What are the 3 things you have to do in Compatibility testing?
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1. ABO/Rh type both patient and donor
2. Antibody screen the patient 3. Crossmatch the donor cells with patient serum |
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Why do you have to do the crossmatch of patient serum to donor cells?
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In case the antibody screen failed to pick up a rare antibody to a rare antigen on the donor cells.
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Is whole blood really a very useful transfusion? Why?
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No; because the plasma is really pretty junky and useless. Why not just give packed RBCs
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What is the main therapeutic use of a whole blood transfusion?
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Increased oxygen carrying capacity, volume repletion
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What is the shelf life of packed RBCs in Adsol?
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42 days
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How much will a packed RBC unit increase a patient's Hb level?
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1 g/dl
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What are 3 compensatory mechanisms in chronic anemia?
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-Decreased blood viscosity
-Increased CO -Increased 2,3 DPG |
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How low can you go in Hb concentration without causing inadequete O2 delivery in healthy volunteers?
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5 mg/dl!!
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What has a generally better outcome in the critical care setting; giving transfusions conservatively or liberally?
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Conservatively
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How much blood volume must be lost for shock to ensue usually?
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30% or more
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Would you give a patient with Vit B12 or folate deficiency anemia a transfusion?
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No; you can treat them more effectively with other means
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What Hemoglobin level would likely call for transfusing?
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6-8 mg/dl, if asyptomatic
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How is Plasma prepared?
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1. Centrifuge out RBCs/WBCs
2. Centrifuge out platlets |
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How much plasma do you get out of a wb donation?
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200-250 ml
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What does fresh frozen plasma contain?
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-All clotting factors
-Coag inhibitors - AT3, Protein S and C |
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How long can FFP be stored?
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Up to 1 yr in -18
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What is the universal PLASMA donor?
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AB (has no antibodies)
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Who can receive type O plasma?
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Only type O
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What is FFP indicated for?
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Replacing coagulation plasma proteins
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What are 3 situations in which you might need to replace plasma proteins for hemostasis?
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-Multi factor deficiency
-Abnormal bleeding/coagulopathy -Prophylaxis for surgery |
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What are 2 things FFP is NOT indicated for?
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-Volume expansion
-Heparin reversal |
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How is cryoprecipitate prepared?
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by spinning down FFP
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What is the main use of cryoprecipitate?
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Replacing fibrinogen
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What is the typical dose of cryo?
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12 units
(1 unit/5 kg body weight) |
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What are the 2 main types of platelet transfusions?
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-Random donor platelets
-Single donor apheresis |
