Transfusions and Apheresis Therapy

Question 1

Average blood volume of an adult?

Answer 1

5 - 6 Liters

70 mL/kg

Question 2

Average ml/kg of blood in a child?

Answer 2

80 mL/kg

Question 3

Average ml/kg of blood in a neonate?

Answer 3

85 - 90 ml/Kg

Question 4

Whole Blood

Answer 4

RBC, Plasma, Platelets, WBC
Nothing removed
Refrigeration for 35 - 42 days

Question 5

Whole blood indications?

Answer 5

Cardiac surgery or massive hemorrhage

Question 6

Packed Cells

Answer 6

Contains packed red blood cells (Hemoglobin)

Refrigeration for 35 - 42 days.

Question 7

Packed cells indications?

Answer 7

Symptomatic Anemia
Need to increase red cell mass
Symptomatic deficit of oxygen carrying capacity

Question 8

Filtered leukocyte - poor RBC’s

Answer 8

WBC’s are removed
prevents febrile reactions and CMV transmission
Use for hx of febrile transfusion rxn.

Question 9

Washed red blood cells

Answer 9

NO plasma, minimal platelets, 90% wbc removal
Can lose RBC’s in process
More expensive
24 hr shelf life.

Question 10

Washed RBC indications

Answer 10

Need to increase red cell mass AND prevent febrile or allergic rxn.
IgA deficieicy

Question 11

Platelets indications

Answer 11

• Thrombocytopenia not caused by increased destruction
• Actively bleeding or to prevent spontaneous bleeding
• Platelet function disorder

Question 12

Fresh Frozen Plasma (FFP)

Answer 12

• Plasma proteins and all coagulation factors.

- Can be stored frozen for one year and thawed for 24 hours.

Question 13

FFP indications

Answer 13

• Tx of stable clotting factor deficiencies for which no concentrates are available.
• Warfarin reversal (emergent bleeding)
• Immediate therapy
• Less than 15,000

Question 14

FFP SE

Answer 14

Disease transmission
Bacteremia (rare)
Transfusion rxn
Volume overload

Question 15

Cryoprecipitate

Answer 15

Concentrated FFP’s, specifically factor VIII (8)

Can be stored frozen for a year

Question 16

Cryoprecipitate Indications

Answer 16

vWD
Hypofibrinogenemia (DIC)
Factor VIII deficiency
DO NOT USE UNLESS SPECIFICALLY INDICATED

Question 17

How long can platelets be stored?

Answer 17

5 days with continuous agitation

Question 18

Which electrolyte can become deficient if transfusions are happening frequently enough (every 5 mins)?

Answer 18

Calcium

Question 19

MIld transfusion rxn symptoms?

Answer 19

MIld temp increase (< 1C)

Rash or Urticaria on < 25% of body

Question 20

Serious transfusion rxn symptoms?

Answer 20

Dyspnea
Bronchospasm
Flank Pain
Hypotension
Shock

Question 21

Apheresis

Answer 21

Removal of blood from body and certain components filtered out, then re-infused.
Used for autoimmune disease