Blood transfusion - Revision history

Aidan: /* Platelets */

2024-10-22T17:25:01Z

Platelets

← Older revision		Revision as of 17:25, 22 October 2024
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	== Platelets ==		== Platelets ==

			* [[Platelet transfusion]]
	* Caution in prothrombotic thrombocytopenia syndromes like [[HIT]], [[TTP]], and catastrophic [[antiphospholipid syndrome]]
	* Of limited utility in [[ITP]]

	=== Indications ===

	* In non-immune thrombocytopenia, it is reasonable to maintain platelets over 10
	* For procedures with low risk of blood loss (e.g. appendectomy, cholecystectomy, vaginal delivery)
	** Platelets less than 20: transfuse 1 dose
	** Platelets 20 to 50: transfuse 1 dose if significant bleeding occurs
	* For procedures with high risk of blood loss, transfuse 1 dose for platelets less than 50
	* For neurosurgery, ophthalmologic procedures, or significant head trauma with high risk of [[intracranial hemorrhage]], maintain platelets above 100 (may need multiple doses)
	* For bleeding from platelet dysfunction (e.g. post-cardiopulmonary bypass, or congenital platelet defect), transfusion may be required regardless of platelet count

	== Plasma ==		== Plasma ==

Aidan: /* Reactions */

2022-02-11T21:25:53Z

Reactions

← Older revision		Revision as of 21:25, 11 February 2022
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	* Not useful when INR less than 1.8, when used 1:1 with RBCs, if there is no pending surgery or bleeding, for the reversal of [[warfarin]], for the reversal of other anticoagulants, or as nutritional support		* Not useful when INR less than 1.8, when used 1:1 with RBCs, if there is no pending surgery or bleeding, for the reversal of [[warfarin]], for the reversal of other anticoagulants, or as nutritional support

	== Reactions ==		== Transfusion Reactions ==
	{\| class="wikitable"		{\| class="wikitable"
	!Risk		!Risk
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	\|Transmission of [[HIV]]		\|Transmission of [[HIV]]
	\|}		\|}

			* Other transmissible infections include:
			** Viruses: [[parvovirus B19]], [[hepatitis A virus]], [[hepatitis E virus]], [[Zika virus]], [[dengue virus]], and [[chikungunya virus]]
			** Protozoa: [[malaria]], [[Chagas disease]], [[toxoplasmosis]], [[leishmaniasis]], [[babesiosis]]
			** Helminths: [[filariasis]]
			** Spirochetes: [[syphilis]], [[Lyme disease]]
			** Rickettsiae: [[Rocky Mountain spotted fever]], [[Coxiella burnetii]], and [[Ehrlichia]]

	=== Fever ===		=== Fever ===

Aidan at 21:23, 11 February 2022

2022-02-11T21:23:02Z

← Older revision		Revision as of 21:23, 11 February 2022
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	** Diphenhydramine 25 to 50 mg IV		** Diphenhydramine 25 to 50 mg IV
	** For anaphylaxis, epinephrine and steroids		** For anaphylaxis, epinephrine and steroids

			=== Cytopenias ===

			* Differential includes [[transfusion-associated graft-versus-host disease]] and [[post-transfusion purpura]]

	[[Category:Hematology]]		[[Category:Hematology]]

Aidan at 02:22, 11 February 2022

2022-02-11T02:22:18Z

@@ Line 59: / Line 59: @@
 * Before a procedure or during active bleeding in patients with severe liver disease and INR greater than 2 times normal
 * Not useful when INR less than 1.8, when used 1:1 with RBCs, if there is no pending surgery or bleeding, for the reversal of [[warfarin]], for the reversal of other anticoagulants, or as nutritional support
 [[Category:Hematology]]

Aidan: /* Indications */

2022-02-11T01:46:44Z

Indications

← Older revision		Revision as of 01:46, 11 February 2022
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	* Before a procedure or during active bleeding in patients with severe liver disease and INR greater than 2 times normal		* Before a procedure or during active bleeding in patients with severe liver disease and INR greater than 2 times normal
	* Not useful when INR less than 1.8, when used 1:1 with RBCs, if there is no pending surgery or bleeding, for the reversal of [[warfarin]], for the reversal of other anticoagulants, or as nutritional support		* Not useful when INR less than 1.8, when used 1:1 with RBCs, if there is no pending surgery or bleeding, for the reversal of [[warfarin]], for the reversal of other anticoagulants, or as nutritional support
	**

	[[Category:Hematology]]		[[Category:Hematology]]

Aidan at 01:32, 11 February 2022

2022-02-11T01:32:42Z

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 ==Red Blood Cells==
 * ABO blood type (O, A, B, or AB)
 ** Most important antigen group
@@ Line 5: / Line 6: @@
 ** Second most important antigen group
 * There are more than 30 minor blood group antigens, including Kell (K and k), Kidd (Jk^a^ and Jk^b^), Duffy (Fy^a^ and Fy^b^) and MNS (S and s)
 ** Group tests recipient for ABO and RhD status
 ** Screen tests the recipient plasma for unexpected and clinically significant minor antigen incompatibility
@@ Line 30: / Line 29: @@
 ** Consider for hemoglobin below 70 g/L in stable patients
 ** Consider for hemoglobin below 80 g/L in patients undergoing orthopedic or cardiac surgery or with cardiovascular disease
 [[Category:Hematology]]

Aidan: Created page with "==Red Blood Cells== * ABO blood type (O, A, B, or AB) ** Most important antigen group * RhD group (positive or negative) ** Second most important antigen group * There are mor..."

2022-02-11T01:17:00Z

Created page with "==Red Blood Cells== * ABO blood type (O, A, B, or AB) ** Most important antigen group * RhD group (positive or negative) ** Second most important antigen group * There are mor..."

New page

==Red Blood Cells==
* ABO blood type (O, A, B, or AB)
** Most important antigen group
* RhD group (positive or negative)
** Second most important antigen group
* There are more than 30 minor blood group antigens, including Kell (K and k), Kidd (Jk^a^ and Jk^b^), Duffy (Fy^a^ and Fy^b^) and MNS (S and s)

===Group & Screen and Crossmatch===
* Group and screen
** Group tests recipient for ABO and RhD status
** Screen tests the recipient plasma for unexpected and clinically significant minor antigen incompatibility
** Takes about 45 minutes, but if the screen is positive then can take days to determine which specific antibodies are causing the problem
* Crossmatch confirms that a specific unit of RBCs is safe to give to the recipient
** If screen was negative, an abbreviated crossmatch is done either as immediate spin or as electronic
** If screen was positive, then a full antiglobulin crossmatch is done

===Basics===
* Each unit is about 300 mL with a hematocrit of 65 to 70%, and raises the recipient's hemoglobin by about 10 g/L
* Usually transfused over 2 hours
** Can do up to 3 or 3.5 hours in elderly over 70 years old, heart failure, LV dysfunction, prior MI, renal dysfunction, or volume overload (usually with concurrent diuretics at the start of the transfusion)

===Indications===
* Acute blood loss
** Maintain hemoglobin above 70 g/L during active bleeding
** Maintain hemoglobin higher (e.g. above 80 g/L) during active bleeding in patients with:
*** Unstable or acute coronary syndrome
*** Coronary artery disease
*** Uncontrolled or unpredictable bleeding
* Anemia
** Consider for hemoglobin below 70 g/L in stable patients
** Consider for hemoglobin below 80 g/L in patients undergoing orthopedic or cardiac surgery or with cardiovascular disease

[[Category:Hematology]]