1.
3 indications for use of Leukocyte reduced blood products: 1) decrease risk of febrile non-hemolytic transfusion reactions
2) to prevent HLA alloimmnunization in patients receiving long term therapy
3) decreasing risk for CMV infection
may also reduce the immunomodulatory effects of transfusion and reduce risk of Crutzfeld-Jacob disease
2.
AABB standard for leukoreduction: <5 x 10^6 residual leukocytes/unit
3.
Components containing RBC's: Whole blood
RBC's leukocyte reduced
RBC's saline washed
RBC's frozen/ deglycerolized
RBC's rejuvenated
4.
Factors that influence oxygen supply: Hgb conc, pp of O2, gas exchange in lungs, cardiac output, blood flow to target organs, tissue demands
5.
RBC: formed from WB products or apheresis
CPDA-1 or additive solution added preservatives
6.
RBC components storage: store at 1-6 degrees celsius
administered through blood filter in 4 hours or less
7.
RBC dose: Adult dose: one unit raises by 1 g/dL
pediatric dose: 8 mL/kg raises by 2 g/dL
8.
RBC frozen/ deglycerolized: glycerol added to CPDA-1 blood less than 6 days old
High glycerol or low glycerol methods
thawed and washed with saline glucose solutions
can be stored up 10 years
9.
RBC frozen/ deglycerolized indications: long term storage of autologous blood
rare blood requirements
does reduce leukocytes but not to full requirements
expensive to prepare, so limited to needs for rare blood
10.
RBC indications: treat anemia in normovolemic patients such as renal failure
decreases risk for volume overload
11.
RBC leukoreduced: prepared from whole blood to remove the majority of leukocytes ( by filtration)
removed pre or post storage- pre is better to reduce the amount of cytokines
can also be collected by apharesis
12.
RBC washed indications: important in the IgA deficient
prevent severe anaphylactic reactions- remove plasma proteins
intrauterine and neonatal transfusion- removes potassium and citrate
13.
RBC's Washed: cells washed with saline and resuspended
leukocyte numbers are reduced, platelet and cellular debris are removed
have decreased storage time, increased cost
14.
Selection of RBC components for transfusion: ABO identical or donor compatible
whole blood must be ABO identical
Rh neg to Rh neg
alloantibodies compatible
15.
Two indicator's for RBC transfusion: 1) RBC products indicated for acute blood loss to stop bleeding and maintain intravascular volume/prevent shock
2)in patients with chronic anemia if signs of hypoxia are present
16.
Whole Blood Contraindications: 1) patients with chronic anemia who are normovolemic
2) patients who are hypovolemic but who do not need red cell mass
3) patients at risk for volume overload
17.
Whole blood dose: one unit raises Hgb by 1 g/dL
in pediatrics 8 mL/kg raises by 1 g/dL
infuse within 4 hours through a filter
18.
Whole Blood indications: for simulataneous increase in red cell mass and plasma volume
reduces donor exposure in mass transfusion
* patients who are actively bleeding and have lost >25% of blood volume, and at risk for hypovolemic shock
