VET433: ECC & Toxicology > Transfusion > Flashcards

Transfusion Flashcards

(43 cards)

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1
Q

what are the 4 indications for transfusion

A
  1. anemia
  2. secondary coagulopathy
  3. thrombocytopenia
  4. hypoproteinemia (rare)
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2
Q

transfusing specific components vs whole blood

A

only want to transfuse the products that the patient needs
- packed RBCs
- platelets
- plasma

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3
Q

RBC transfusion indication

A

anemia

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4
Q

transfusion triggers for RBCs

A
  1. PCV = 20-22%
  2. ongoing losses (transfuse sooner)
  3. chronicity
  4. clinical response to anemia (transfuse later if patient compensating)
  5. underlying/concurrent disease
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5
Q

RBC products

A
  • fresh whole blood
  • stored whole blood
  • packed RBCs
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6
Q

transfusion volume - RBCs

A

goal: PCV = 25%

pRBCs: 1-1.5 mL/kg
whole blood: 2 mL/kg
(to increase PCV by 1%)

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7
Q

indications for plasma transfusion

A
  1. acquired secondary coagulopathy w/ serious bleeding (rodenticide, liver failure, heat stroke, DIC)
  2. bleeding w/ congenital coagulopathy
  3. clinical signs of secondary coagulopathy
  4. coagulation testing - prolonged PT/PTT, ACT, etc
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8
Q

products for transfusing plasma

A
  • fresh plasma: all factors
  • fresh frozen plasma: all factors
  • frozen plasma: stable factors (vit K dependent)
  • cryoprecipitate: labile factors
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9
Q

transfusion volume - plasma

A

10-15 mL/kg minimum
titrate to effect

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10
Q

indications for platelet transfusion

A
  1. severe thrombocytopenia w/ severe hemorrhage (<10,000)
  2. moderate thrombocytopenia w/ planned invasive procedure (>50,000)
  3. massive transfusions
  4. thrombocytopathy
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11
Q

platelet transfusion products

A

SHORT half life

  1. fresh whole blood
  2. platelet rich plasma
  3. platelet concentrate
  4. cryopreserved platelets
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12
Q

transfusion volume - platelets

A

1 unit/kg
titrate to effect

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13
Q

is it common to transfuse albumin?

A

no

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14
Q

what is blood type determined by

A

antigens present on RBC surface

genetically determined
species specific
antigenic in individuals that lack the same marker

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15
Q

what is the major dog blood type antigen

A

DEA-1

strongly antigenic
generates a strong alloantibody response AFTER sensitization

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16
Q

do dogs have naturally occurring antibodies against DEA-1

A

NO

DEA-1 negative dogs do NOT have natural antibodies against DEA-1

will develop antibodies AFTER sensitization (ex. previous transfusion with DEA-1 blood)

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17
Q

DEA-1 negative donors and recipients

A

donate to DEA-1 + and -
receive from DEA-1 - only

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18
Q

DEA-1 positive donors and recipients

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A

donate to DEA-1 + only
receive from DEA-1 + and -

19
Q

when is crossmatching required for dogs

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A

if transfusion has occurred > 3 days ago
OR
unknown history

recommended but not required for first transfusion

20
Q

what are the cat blood typing antigens

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A

AB blood groups
MiK antigen

21
Q

type A cat blood

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A

majority of DSH/DLH and non-pedigree cats

has WEAK anti-B natural antibodies

22
Q

type A donors and recipients

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A

donate to A and AB
receive from A only

23
Q

type B cat blood

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A

has STRONG anti-A antibodies

24
Q

type B donors and recipients

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A

donate to B only
receive from B only

25
what happens if type A blood is donated to a type B cat
marked hemolysis B recipient has strong anti-A antibodies
26
what happens if type B blood is donated to a type A cat
minor hemolytic reaction A recipient has weak anti-B antibodies
27
type AB cat blood
rare - certain purebred cats only has type A and B antigen NO naturally occurring antibodies
28
type AB donors and recipients
donate to AB only receive from A only B blood will have a strong reaction against the A antigen
29
when is crossmatching required for cats
ALL transfusions due to naturally occurring antibodies and because MiK is not determined on blood typing - should cross match
30
blood typing
identifies the primary red cell surface antigen of the donor and recipient
31
crossmatching
identifies any blood group abnormalities beyond the single surface antigen major: tests for antibodies in the recipient plasma against donor RBCS minor: tests for antibodies in the donor plasma against recipient RBCs
32
what to do in emergency situation (dogs and cats) if you do not have time to crossmatch
dogs: type OR give DEA-1 neg pRBCs cats: type or watch for agglutination on slide - if only A blood available - give anyway if patient will die without transfusion
33
acute transfusion reactions
occurs within 24 hours of transfusion
34
delayed transfusion reactions
occurs after 24 hours of transfusion
35
febrile non hemolytic transfusion reaction (FNHTR)
increase in temperature with NO other clinical signs of reaction - T > 39C (102.5F) and increase in temp >1C or 1.8F MOST COMMON
36
FNHTR pathogenesis and treatment
reaction to WBC or platelet antigen-antibody reactions NOT a reaction to the RBC antigen tx: slow or stop transfusion and rule out other causes of fever - can restart
37
acute hemolytic transfusion reaction (AHTR)
type II hypersensitivity reaction in which the recipient antibodies react with donor RBC antigen --> ACUTE LYSIS of transfused cells leads to CV collapse, hemoglobinemia/uria, fever
38
delayed hemolytic transfusion reaction (DHTR)
low levels or delayed production of antibodies causing a hemolytic reaction >24 hours after transfusion (slow hemolysis) not common
39
allergic reactions
type I hypersensitivity reaction to foreign proteins in blood CS: urticaria, pruritus, swelling, GI signs, anaphylaxis TX: slow or stop transfusion, diphenhydramine, epinephrine do NOT give corticosteroids
40
transfusion associated circulatory overload (TACO)
respiratory reaction volume overload leads to hydrostatic pulmonary edema within 6 hours of transfusion tx: O2 supplementation, ventilatory support, furosemide
41
how to administer transfusion
use a filter on administration set rate: 1. first 15 min: 2.5 mL/kg/hr 2. end goal: 5 mL/kg/hr
42
transfusion monitoring
temperature HR RR mentation PCV +/- coags PRN
43
are predmedications indicated to prevent allergic reactions
NO
VET433: ECC & Toxicology
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