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Adult blood volume is calculated from the formula 70mL/kg of weight. Please calculate the blood volume of an adult who weighs 122 lbs. (To convert from lbs. to kg. divide by 2.2)
3882 mL; 7.8 lbs. / 2.2 = 3.55 kg x 100 = 355 mL
Infant blood volume is calculated from the formula 100mL/kg of weight. It is important to be able to estimate the blood volume of an infant. Removal of 10% of an infant's blood volume in a short amount of time can lead to serious consequences. Please calculate the blood volume of an infant who weighs 7.8 lbs?
355 mL; 70 x 70 = 4900 mL
What is the blood volume of an adult male who weighs 70 kg?
4900 mL; 70 x 70 = 4900 mL
Please calculate the vials of RhIg (standard dose) to be given if 14 fetal cells are counted in a KB stain. The maternal weight is 140 lbs.
2 vials; 140 / 2.2 = 63.6 kg x 70 = 4452 mL (14 x 4452) / 2000 = 31.16 / 30 = 1.03 (round down and add 1).
Please calculate the vials of RhIg (standard dose) to be given if 52 fetal cells are counted in a KB stain. The maternal weight is unknown.
5 vials; (52 x 5000) / 2000 = 130 mL FMH / 30 = 4.3. (round down and add 1).
5 vials (IV preparation likely to be given to spare the patient 5 injections)
A male A-negative patient was transfused a unit of A-positive packed red blood cells (pRBCs) in error. NOTE: The patient was transfused with packed cells, not whole blood.
The mistake was noticed after the patient was transfused 44 mLs of the blood. Please calculate the dose of RhIg (standard) to be injected to this patient to prevent stimulation of alloanti-D.
4 vials; 44/15 = 2.9 (Round up and add 1)
4 vials (IV preparation likely to be given to spare the patient 4 injections)
A 6-month-old pediatric patient is B-negative. She has received a unit of platelet pheresis that appeared to be bloody. The estimated blood volume in the unit of platelets is estimated to be 5 mLs. Please calculate the dose of RhIg (standard) to be injected to this patient to prevent stimulation of alloanti-D.
(HINT: It's estimated that 5 mL of red blood cells are in the unit of platelets, so think of the 5 mL volume of red blood cells as being "packed cells," rather than whole blood).
1 vial; 1 vial of the standard dose would be sufficient. Also, a Microdose of 50μg would protect against 5 mL of whole blood, can be given to pediatric patients.
Please select the special needs for and optimal HCT of blood to be given in an intrauterine transfusion.
-Antigen-negative for any antigens toward which the maternal antibody is directed
-HCT > 70%
-7-days old or fresher (preferred)
-Irradiated to prevent TA-GvHD
-Rh compatible; ABO compatible (usually type O)
Rh compatible (usually negative)
Antigen negative for the antigen against which maternal antibody is directed (e.g., if maternal antibody is anti-K, unit should be K negative)
Generally, RBCs collected within 7 days of use are preferred
Leukocyte Reduced (almost all donor blood is now leukocyte reduced)
Irradiated to prevent GvHD in the immunologically immature fetus
Hemoglobin-S negative to prevent sickling under low oxygen tension
Washed (per facility. Irradiation increases potassium levels. Also, one unit of CPDA-1 donor packed cells has approx. 70 mL plasma. If type O can contain anti-A,B, which can be a problem if fetus is type A or B. Washing removes both excess K+ and plasma)
HCT > 70%
Please select the special needs for and optimal HCT of blood to be given in a neonatal exchange transfusion.
-Antigen-negative for the antigens toward which the maternal antibody is directed
-Irradiated to prevent TA-GvHD
-7 days old or fresher (preferred)
-Rh compatible; Considerations for neonatal exchange are the same as intrauterine transfusion except packed cells are pooled with AB plasma at HCT level generally between 45-55% (The physician orders the specified HCT).
Please explain the primary difference in pathophysiology in hemolytic disease of the fetus and in hemolytic disease of the newborn.
Is the following statement true or false?
"In hemolytic disease of the newborn (HDN), hyperbilirubinemia leading to potential kernicterus is the main concern. In hemolytic disease of the fetus (HDF), fetal anemia is the main concern because the maternal liver can conjugate the excess bilirubin."
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