1 / 16

Transfusion Medicine

Transfusion Medicine. Nate Falk, MD Family Medicine Residency Clinic. Blood products. Whole blood Cellular PRBCs Platelets Plasma FFP Cryoprecipitate Other proteins. Whole blood. Slow centrifuge – PRBC and platelet rich plasma Fast centrifuge – Platelets and FFP

cher
Download Presentation

Transfusion Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Transfusion Medicine Nate Falk, MD Family Medicine Residency Clinic

  2. Blood products • Whole blood • Cellular • PRBCs • Platelets • Plasma • FFP • Cryoprecipitate • Other proteins

  3. Whole blood • Slow centrifuge – PRBC and platelet rich plasma • Fast centrifuge – Platelets and FFP • Thaw and centrifuge FFP to get Cryo

  4. Whole Blood • Roughly 450 mL • Best used for acute blood loss and hypovolemia – 25% volume loss

  5. PRBCs • 180-200 mL • Transfusion indications? • How much? • May be leukoreduced if concerned about CMV transmission (reduces WBC count to < 5 million

  6. Platelets • 50-70 mL per unit • 1 unit raises by 5-10K • Usually give 6 units per time • Either random donor or single source • Usually use single source for people who will need multiple platelet transfusions – collected by apheresis

  7. Fresh Frozen Plasma • 200-250 mL/unit • Contains plasma proteins • Good for INR problems • Need IgA free for pt’s w/ IgA deficiency

  8. Cryoprecipitate • 10-15 mL • Fibrinogen, Factor 8, vWF • Used for factor 8 and vWF replacement

  9. Plasma proteins • Usually made from multidonor batches • Includes: • Albumin • IVIG • HBV Ig • Tetanus Ig

  10. Complications • Viral infection • Bacterial infection/contamination • Immunologic reactions • Non-immunologic reactions

  11. Viral infection risk • Risk depends on location that blood is collect (lower risk in Canada) • HBV – 1:60-250K • HCV – 1:1.9 million • HIV – 1:2.1 million

  12. Bacterial • Depends on where collected • Malaria 1:4 million – rising • Chagas • Contamination – PRBCs - yersinia, pseudomonas, serratia, e.coli (can all grow in 1-6 degree) • Platelets – staph (1:5000) – stored at room temp

  13. Immunologic Reactions • Fever (4:100) • Delayed mild hemolytic (1:1000) • Acute hemolytic (1:12,000) • Fatal hemolytic (1:100,000) • Anaphylaxis (1:150,000)

  14. Incompatibilities • ABO • Rh • Lewis (oligosaccharide) • Kell • Duffy • Kidd • MNSsU • I/I (carbohydrate)

  15. Blood typing • Type – ABO, Rh • Screen – look for other alloantibodies (usually used if you suspect that the pt may not need a transfusion, but needs blood available just in case) • Cross – essentially mix and look for reaction (this also reserves that specific unit for the patient)

  16. Non-immunologic Complications • Volume overload • Hypothermia • Iron overload (repeated transfusions) • Transient hypotension – occurs in pt’s on ACE inhibitors secondary to bradykinin in blood • Electrolyte disturbances • HyperK • Hypocalcemia (citrate used as anticoagulant)

More Related