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BLOOD TRANSFUSIONS (extra notes from KATIE!!

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I. Transfusion therapy II. Whole blood III. Prbc=packed red blood cells IV. Plasma: fresh frozen (ffp) or frozen (fp) A. Transfusions are given not only for red blood cells, but also For other blood components as plasma and coagulation factors B. Fresh whole blood can be separated into four components: 1. Red cells 2. Platelet rich plasma 3. Fresh frozen plasma 4. Cryoprecipitate – Factor VIII , Von Willondbrands C. Transfusions may be indicated for the following: 1. Anemia 2. Coagulopathy 3. Thrombocytopenia-no platelets 4. Hypoproteinemic 5. Pancreatitis-fresh frozen plasma Blood types A. Blood types are genetic markers on the red cell that are antigenic and specific for each species. B. These alloantibodies are the cause of transfusion reactions and neonatal isoerythrolysis. C. Canine blood types 1. Dogs system known as DEA ( Dog Erythrocyte Antigen ) 2. Blood types can be positive and negative 3. Types a. DEA 1 DEA 1.1 ( A1 ) DEA 1.2 ( A2 ) b. DEA 3 B c. DEA 4 C d. DEA 5 D e. DEA 7 tr D. Feline blood types 1. Cats have three blood types : A, B, AB 2. Type A is the most dominant, while AB is rare

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thus crossmatch should Show compatibility b. A/A or A/B are both type A c. Only B/B is type B Crossmatching A.VI. Crossmatching tests for alloantibodies. Donor criteria-need to know!!!! a. but does not determine 1. Incompatibility of crossmatch shows hemolysis or agglutination on crossmatch slide D. Dogs and 4 kg. Cats have naturally occurring alloantibodies c. First time transfusion ok C. Dogs do not have naturally occurring alloantibodies. B. Disease free and current vaccines d. Anticoagulent used Citrate-phosphate-dextrose-adenine ( CPD-A ) . Blood Donors 1. Warm to room temp before admin:warm water NOT HOT!!! At 50 fibrinogen precipitates At 45 RBC will agglutinate Filter needed when admin cell products (prevent thromboemboli-blood clot) -diff type:18. used more for dogs Transfusion Admin. Blood typing cards exist for dogs and cats. 4. 260 -white blood cell filter:18 microns with WBC filters VII. Blood type a. Cat 10ml/kg or 50mls. Cats 2. Type A is expressed when ever A is present b. Pcv > 40 % in dog b. Should not donate blood sooner then 4 weeks after Blood donation 3. Maximal volume to be donated a. 170. Blood Sources A. a. Pcv > 35 % in cat c. Blood crossmatching test the serological incompatibility and Compatibility between the donor and recipient. Weight at least 25 kg. Dog 20 ml/kg or 450 mls. b.

Monitor Body Temperature every 5 minutes-first symptom of reaction will be increase in body temperature and then panting. Treat transfusion reactions with Diphenhydramine and Dexamethasone. Warm to room temperature before administration B. 10 ml/kg/hr to 22 ml/kg/hr 2. May premedicate with these medications before transfusion. Whole blood – 4 o C for 1 month 2. 3. Rate depends on disease and patients status-generally give over 4 hours 1. Transfusion administration A. then increase rate if no complications. D. Calculations PCV desired – PCV recipient Volume to be given = 2. Hypotension and bradycardia b. Filters are needed during transfusions to prevent thromboemboliblood clots F. 1 lm/lb of weight increases PCV by 1 % E.B. Storage 1. (kg) x (30 dog or 40 cat) x PCV of donor in anticoagulant Transfusion Reactions A.2 x recipient wt. Fresh frozen plasma . C.< 20 o C up to 1 year VIII. Start transfusion slow the first ½ hours. Platelet rich plasma – 24 hours 4. Packed red blood cells – 4 o C 1 month 3. Most common is fever. Vomiting and diarrhea . Phase I ( Anaphylaxis ) a. 2. Rate guide lines 1. a. followed by vomiting and diarrhea B.

c. bilirubinuria b. seizures and nystagmus Phase II ( Hemolytic ) a. Hemolysis.C. Tachycardia. Lethargy. hemoglobinemia. DIC. death .

Seal the tubing close to the bag and at several places up to the tube. to total of two to three times the volume of blood removed (1 liter commonly used). 9) Set bag on scale when appears full (moderately distended.05 mg/kg (max usually required is 1. 12) Recover the dog in a cage and observe for any untoward events. usually gravity filled (suction may be used) Scale to measure 587 g [450 + 45 mls (470 + 48 g) blood + weight of bag and anticoagulant (117 g)].2 mg/kg butorphanol given IM 15 min prior to collection. . Cut the tube between the seals (sausages) to obtain samples. Mix the bag and release the stripper to allow the blood to flow back into the tube. mucous membrane color and capillary refill time. Check pulse rate. Regular donors usually do not require sedation 1L bag Plasma-lyte – 148 IV set (10 drops/ml) Blood Pack with CPDA-1. hold the tubing. 6) Surgically prepare the jugular area. inserts the 16 gauge needle into the jugular vein (toward the heart) and collects the 450 ml blood while rocking the bag to disperse the anticoagulant throughout the collection. 3) Clip and surgically prepare the cephalic venipuncture site. not tight). 2) Clip area over the jugular vein approximately 4” x 4”. Repeat three times. 8) The first person. 7) A second person restrains the dog in lateral recumbency with one hand compressing the jugular vein. by the clock!) 11) Rapidly infuse fluids. 3 x 3 gauze squares Adhesive tape (split lengthwise in half) 19 gauge butterfly or 20 gauge IV catheter Clippers Sedation 0.CANINE BLOOD COLLECTION TECHNIQUE Supplies • • • • • 10. For heavy sedation propofol 4 mg/kg or less IV OR thiopental 10 mg/kg or less IV to effect (beware hypotension?). administer oxymorphone or butorphanol (no acepromazine). Minimum acceptable underdraw for whole blood is 405 ml (429 g) and for packed cells is 300 ml (318 g). 5) If sedation is necessary at this point. Maximum overdraw is 495 ml (525 g). Strip the tubing to allow the blood to go into the bag. • • • • Technique (2 persons) 1) Jugular and cephalic veins are alternated for each donation. seal the tubing a distance from the bag. with freshly washed hands.5mg) oxymorphone or 0. hold off vessel to minimize hematoma (5 minutes minimum. plus 117 g. 13) After blood collection. 4) Place the cephalic catheter and begin slow administration of crystalloid solution. The neck should be extended slightly. This mixing allows the anticoagulant to mix with the blood so when PCV and TS is obtained it accurately reflects that of the bag. under pressure. 10) Upon completion.

to prevent hematoma.WHOLE BLOOD COLLECTION FROM FELINE DONORS Supplies • • • • • • 10 x 3 x 3 gauze squares 2. 12) Test blood for PCV/TP without contaminating the blood collected. 8) While collecting 51. remove butterfly from the jugular vein and apply pressure to the venipuncture site for 5 minutes. 5) Sedation. remove syringe from butterfly and cap with a sterile 20-gauge needle.2 mg/kg IM. 4) Surgically prepare the jugular are.9% saline). then ketamine 10mg/kg IM 5 minutes later with a 25 gauge needle injecting slowly. inserts the 19 g butterfly needle into the jugular and connects the butterfly tube to the syringe containing the anticoagulant. if no cephalic IV access. 6) A second person holds the cat in sternal recumbency. 7) First person with freshly washed hands. . 2) Clip are over the jugular vein approximately 2” x 2”. (I) ketamine/diazepam 0. (easier to split anticoagulant into 2 – 35 ml syringes) Artificial Tears or ointment for eyes Technique (2 Persons) 1) Check records – jugular and cephalic veins are alternated for each donation. 11) Recover the cat in a cage in a quiet/dark area. 9) Upon completion. by the clock. with the head up and front limbs hanging over the tabletop edge.5 ml CPDA-1 anticoagulant 60 ml syringe (load CPDA-1 in syringe).5 ml blood remember to mix the anticoagulant in blood by inverting the syringe.1 ml/kg of mixture [1/2 ml ketamine (100 mg/ml) + 1/2ml diazepam 10mg/2 ml)] IV or (ii) midazolam 0. OR in lateral recumbency with head extended and compression applied to the jugular vein. 3) Clip and surgically prepare cephalic for placement of butterfly catheter. 19 gauge butterfly catheters Clippers 8. 10) Give 120 –180 ml warm fluids IV through cephalic or jugular catheter or SC (0. If cephalic assess.