Term
What is the main objective for RBC administration? |
|
Definition
Improvement of inadequate oxygen delivery |
|
|
Term
|
Definition
- A loss of 15% total blood volume
- usually has little effect hemodynamially, other than vasoconstriction and mild tachycardia
|
|
|
Term
|
Definition
- loss of 15-30% of total blood volume
- produces tachycardia and a decreased pulse pressure
- may cause anxiety and restlessness in unanesthetized pts
|
|
|
Term
|
Definition
- 30-40% total blood loss
- produces signs of hypovolumeia, marked tachycardia, tachypnea, systolic hypotension
- altered mental status in unanesthetized pts
- can be treated with crystaloid in healthy young pts
|
|
|
Term
|
Definition
- loss of ≥ 40% total blood loss
- life threatening
- marked tacycardia, hypotension, very narrow pulse pressure, low urine output
- mental status markedly depressed
|
|
|
Term
risks of diminished oxygen carrying capacity? |
|
Definition
|
|
Term
define oxygen-carrying capacity? |
|
Definition
|
|
Term
Difference between chronic and acute anemia? |
|
Definition
|
|
Term
Recommendations of RBC transfusions? |
|
Definition
1. Transfusion is rarely indicated when the hemoglobin concentration is greater than 10g/dl, and is almost always indicated when it is less than 6g/dl, especially when the anemia is acute. 2. The determination of whether intermediate hemoglobin concentrations (6-10g/dl) justify or require RBC transfusion should be based on the patient’s risk for complications of inadequate oxygenation. 3. The use of a single transfusion “trigger” (ei 10/30 rule) for all patients is not recommended. 4. When appropriate, preoperative autologous blood donation, intraoperative and postoperative blood recovery, acute normovolemic hemodilution, and measures to decrease blood loss (deliberate hypotension and pharmacologic agents) may be beneficial. 5. The indications for autologous RBCs may be more liberal than allogenic RBCs because of the lower (but still significant) risk associated with autologous transfusions. |
|
|
Term
Risks of administration of RBCs? |
|
Definition
transfusion rxns- fever, chills, urticaria Infectious dx transmission- CMV most common
|
|
|
Term
|
Definition
Hemolysis elevated liver enzymes low platelet count
Related to thrombocytopenia associated with preeclampsia |
|
|
Term
Recommendations for platelet administration? |
|
Definition
1. Prophylactic platelet transfusion are ineffective and rarely indicated when thrombocytopenia is due to platelet destruction (e.g. idiopathic thrombocytopenic purpura). 2. Prophylactic platelet transfusion is rarely indicated in surgical patients with thrombocytopenia due to decreased platelet production when the platelet count is greater than 100,000, and is usually indicated when less than 50,000. The determination of whether patients with intermediate (50,000-100,000) require therapy should be based on the risk of bleeding. 3. Surgical and obstetric patients with microvascular bleeding usually require platelet transfusions if the platelet count is less than 50,000, and rarely require transfusion if platelet count is greater than 100,000. With intermediate thrombocytopenia (50,000-100,000) the determination should be based on the risk of more significant bleeding. 4. Vaginal deliveries or operative procedures associated with insignificant blood loss may be undertaken with platelet counts less than 50,000 5. Platelet transfusions may be indicated despite an apparently adequate platelet count if there is known platelet dysfunction and microvascular bleeding. |
|
|
Term
Recommendations for FFP transfusion? |
|
Definition
1. FFP is indicated for urgent reversal of warfarin therapy. 2. For correction of known coagulation factor deficiencies for which specific concentrations are unavailable. 3. For correction of microvascular bleeding in the presence of elevated (>1.5 times normal) PT or PTT. 4. For correction of microvascular bleeding secondary to coagulation factor deficiency in patients transfused with more than one blood volume when PT and PTT cannot be obtained in a timely fashion. 5. FFP should be given in doses calculated to achieve a minimum of 30% of plasma concentration (10-15ml/kg of FFP), except for urgent reversal of warfarin anticoagulation, for which (5 -8ml/kg of FFP) will usually suffice. 4-5 platelet concentrations, or one unit of whole blood provide a quantity of coagulation factors similar to that contained in one unit of FFP (except for decreased, but still hemostatic concentrations of factors V and VIII in whole blood). 6. FFP is contraindicated for augmentation of plasma volume or albumin concentration. |
|
|
Term
What are the components of cryoprecipitate? |
|
Definition
- Factor VIII
- Fibrinogen
- fibronectin
- vWF
- factor XIII
|
|
|
Term
Recommendations for use of cryoprecipitate? |
|
Definition
1. Prophylaxis in nonbleeding perioperative or peripartum patients with congenital fibrinogen deficiencies or von Willibrand’s disease unresponsive to DDAVP. 2. Bleeding patients with von Willibrand’s disease. 3. Correction of microvascular bleeding in massively transfused patients with fibrinogen concentrations less than 80- 100mg/dl (or when fibrinogen concentrations cannot be measured in a timely fashion). |
|
|
Term
Indications for use of Albumin? |
|
Definition
|
|
Term
Indications for use of plasma protein fraction? |
|
Definition
|
|
Term
|
Definition
|
|
Term
What agents are used as volume expanders? |
|
Definition
|
|
Term
Advantages of Hetastarch compared to Albumin? |
|
Definition
|
|
Term
Adverse reactions of Hetastarch? |
|
Definition
|
|
Term
Indications for use of Dextran? |
|
Definition
|
|
Term
Adverse reactions associated with Dextran administration? |
|
Definition
|
|
