Blood Products
This blood product contains Factors I, VIII, XIII, and von Willebrand factor.
This blood product contains all coagulation factors, inhibitors, and antithrombin III.
What is FFP (Fresh Frozen Plasma)?
What is Cryoprecipitate?
Normal INR range.
What is approximately 0.8-1.2?
This drug irreversibly inhibits cyclooxygenase.
What is Aspirin?
This transfusion complication is immune-mediated pulmonary edema.
What is TRALI?
Collection and storage of the patient's blood weeks before surgery.
What is preoperative autologous donation?
Platelet count below this value commonly causes microvascular bleeding requiring transfusion.
What is 50,000?
What is the most essential regulator of erythropoietin and RBC production?
What is tissue oxygenation?
A patient's ABG shows:
Calculate the dissolved oxygen content.
Formula:
Dissolved O₂ = PaO₂ × 0.003
Answer: 0.27 mL/dL
A trauma patient develops massive hemorrhage.
Labs:
The patient receives cryoprecipitate.
What fibrinogen level would be expected after therapy?
Approximately 180 mg/dL
Rationale:
Cryoprecipitate: 1 unit/5kg will raise fibrinogen by 100 mg/dL
Heparin therapy is routinely monitored using this laboratory test.
What is aPTT?
This drug increases endogenous release of von Willebrand factor.
What is Desmopressin?
This transfusion complication is associated with elevated left atrial pressure.
What is TACO?
Removal of blood before incision while maintaining volume with crystalloid or colloid.
What is acute normovolemic hemodilution?
Fibrinogen level below this value may warrant cryoprecipitate.
What is 100 mg/dL?
Which substances naturally inhibit platelet function?
What is Prostaglandin and Nitric Oxide?
A patient's ABG shows:
Calculate the dissolved CO₂ content.
Formula:
Dissolved CO₂ = PaCO₂ × 0.067
Answer: 3.22 mL/dL
A patient has a hematocrit of 24%. After receiving 3 units of PRBCs, the expected hematocrit is approximately:
What is 33%?
Rationale: One unit of PRBCs typically increases hematocrit by 2% to 3%.
Therapeutic heparin should produce this aPTT range.
What is 1.5-2.5 times normal?
This drug directly inhibits Factor Xa.
What is Apixaban?
A PAOP ≤18 mmHg supports this diagnosis.
What is TRALI?
Collection, washing, and reinfusion of shed surgical blood.
What is intraoperative cell salvage?
A patient with severe liver disease presents for surgery.
Labs:
The surgical team requests prophylactic FFP because the INR is elevated.
Based on current understanding of liver disease-associated coagulopathy, what is the best response?
What is "Do not transfuse solely based on INR in the absence of bleeding"?
Rationale: Liver disease decreases clotting factors and natural anticoagulants (Protein C, Protein S, Antithrombin III). Other tests like TEG/ROTEM is often more useful.
What mediators cause vasoconstriction?
What is thromboxane A2 and ADP?
A patient has:
Calculate:
Bound:
12 × 1.34 × 0.97 = 15.60
Dissolved:
100 × 0.003 = 0.30
Answer: 15.90 mL/dL mL/dL
DAILY DOUBLE
A 70-kg patient develops diffuse microvascular bleeding during surgery.
Labs show:
The anesthesia provider administers FFP. What would you expect to happen to your coagulation factor levels?
An increase in coagulation factor levels by approximately 20–30%.
Rationale:
When high-dose heparin is used during cardiac surgery, this test is monitored instead.
What is ACT?
This drug directly inhibits thrombin and is commonly used for HIT.
What is Argatroban?
Treatment includes diuretics and afterload reduction.
What is TACO?
This autologous technique is contraindicated with bowel contamination.
What is cell salvage?
A 72-year-old patient undergoing emergent abdominal surgery has the following labs:
The patient takes warfarin for atrial fibrillation.
The anesthesia provider wants the fastest correction of the coagulopathy.
What is FFP?
A patient is:
Which blood type can be safely transfused?
A. B+
B. AB+
C. O−
D. B−
O-
A trauma patient has:
Calculate:
Bound:
8 × 1.34 × 0.92 = 9.86
Dissolved:
70 × 0.003 = 0.21
Answer: 10.07 mL/dL
A patient undergoing liver transplantation has:
You transfuse 1 unit of platelets.
What is their expected platelet count?
45,000-50,000
Normal ACT range.
What is approximately 80-120 seconds?
DAILY DOUBLE
This drug competitively inhibits conversion of plasminogen to plasmin. What is another med that we commonly use that does this?
What is Aminocaproic Acid?
What is TXA?
A patient develops bilateral infiltrates, hypoxemia, and normal cardiac filling pressures 6 hours after receiving FFP.
What is TRALI?
DAILY DOUBLE
Major risk associated with cell salvage despite washing.
What is dilutional coagulopathy?
Despite thrombocytopenia, this heparin complication produces a hypercoagulable state.
What is HIT Type II?
Slide 26
Rh-negative mother is carrying a Rh-positive fetus. Sensitization of the mother to fetal Rh antigens may result in which neonatal condition?
Which medication is administered to reduce maternal sensitization?
What is Erythroblastosis fetalis?
What is Rh immunoglobulin?
A 70-kg male patient has:
Calculate the allowable blood loss.
EBV:
70 × 75 = 5250
ABL:
5250 × (42−30)/42
Answer: 1500 mL