CHAPTER 49. QUIZ 5. Synthetic Oxygen-Carrying Substances AND allogenic blood

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What is the main advantage of Hb-based O2 carriers (HBOCs) over human blood?

Carry oxygen only when Pao2 is more than 300 mm Hg

Do not require type and crossmatch (correct)

Transmit infectious viruses

Require type and crossmatch

Which perfluoro compound carries three to four times more oxygen than Fluosol-DA?

Perfluorochemical emulsion

Perfluorooctanoic acid

Perfluorooctyl bromide (correct)

Fluosol-DA

What characteristic is required by most HBOCs to prevent nephrotoxicity?

Right shift in the O2 dissociation curve

Low O2 affinity

Stroma-free Hb (correct)

High O2 affinity

Which synthetic blood product was initially approved for perfusion of ischemic tissues?

Fluosol-DA Signup and view all the answers

What is the main issue with stroma-free Hb as mentioned in the text?

Causes microvascular vasoconstriction Signup and view all the answers

What was a significant finding of Natanson and colleagues' meta-analysis on HBOCs?

Increased risk for myocardial infarction and death Signup and view all the answers

What distinguishes Hemopure (HBOC-201) from human RBCs based on the text?

Higher P50 value Signup and view all the answers

What is the role of HBOCs according to the text?

Reserve for situations where RBC transfusion is not possible Signup and view all the answers

What is one of the distinct procedures that autologous blood transfusion constitutes, according to the text?

Postoperative blood salvage Signup and view all the answers

What is one of the aims of autologous transfusion mentioned in the text?

To decrease the severity of complications associated with allogenic transfusions Signup and view all the answers

What criterion must most donors meet prior to preoperative autologous donation according to the AABB?

Hemoglobin level of no less than 11 g/dL Signup and view all the answers

What is the recommended time interval between repeated donations for preoperative autologous donation?

1 week Signup and view all the answers

Why is there a 72-hour interval required between the last donation and the time of surgery for preoperative autologous donation?

To allow restoration of intravascular volume and preparation of the donated blood Signup and view all the answers

According to the Hemoglobin and Iron Recovery Study (HEIRS), how long does it take for recovery of 80% red cell mass after preoperative autologous donation?

25 to more than 168 days Signup and view all the answers

What is the effect of preoperative autologous donation (PAD) on the risk of receiving a transfusion from any source?

Increases by 24% Signup and view all the answers

Why are certain patient populations considered poor candidates for PAD?

because of their underlying comorbidities Signup and view all the answers

How does the hospitalization rate post PAD compare between American Red Cross donors and allogenic donors?

PAD donors have nearly 12 times the hospitalization rate of allogenic donors Signup and view all the answers

In what way does PAD affect the hemoglobin levels compared to those who do not donate preoperatively?

Hb is 1.1 g/dL lower in PAD patients Signup and view all the answers

which one is considered Contradictions to Participation in Autologous Blood Donation Programs

Scheduled surgery to correct aortic stenosis Signup and view all the answers

How much RBC mass is saved by minimal ANH compared to a patient's blood volume?

100 mL Signup and view all the answers

What do retrospective data suggest about the impact of even mild ANH?

Improves outcomes Signup and view all the answers

In which type of surgeries has ANH been shown to decrease transfusion requirements according to randomized trials?

Hip replacement surgery Signup and view all the answers

How many allogenic blood units were patients who underwent ANH receiving compared to control groups on average?

Three-fourths fewer Signup and view all the answers

What potential complication was observed in adult animal models receiving ANH transfusions?

Bronchoconstriction Signup and view all the answers

What protective effect does ANH have specifically during cardiac surgery?

Prevents platelet dysfunction Signup and view all the answers

What should be considered when making decisions about using ANH?

Patient's vital signs and blood volume Signup and view all the answers

What is the major benefit of Acute Normovolemic Hemodilution (ANH) mentioned in the text?

Reduced shedding of red blood cells during bleeding Signup and view all the answers

What is the purpose of reversing the order of blood collection during ANH when reinfusing the sequestered blood?

To maintain the highest hemoglobin level in the reinfused blood Signup and view all the answers

What is the recommended storage temperature for collected blood during Acute Normovolemic Hemodilution (ANH), as mentioned in the text?

4°C for up to 24 hours Signup and view all the answers

How do thromboelastography (TEG) measurements differ between samples agitated during storage and those left stationary, according to the text?

No notable differences have been observed Signup and view all the answers

What does the term 'intraoperative cell salvage' refer to?

Collecting and reinfusing blood lost during surgery Signup and view all the answers

What is a general indication for the use of cell salvage according to the AABB guidelines?

Expected need for more than one unit of red blood cells Signup and view all the answers

Which anticoagulants are commonly used in the blood collection process of cell salvage?

Heparin or Citrate Signup and view all the answers

When is cell salvage considered acceptable for use with patients who do not consent to allogeneic transfusions?

When the patient is unwilling to accept allogeneic blood Signup and view all the answers

What is one of the main purposes of intraoperative cell salvage during surgery?

To reduce the need for allogenic blood transfusions Signup and view all the answers

Which scenario would make a patient a good candidate for cell salvage?

Patient anticipates a high volume of blood loss Signup and view all the answers

What process separates the lower density plasma and anticoagulant fluid from the higher density RBCs in processing?

Centrifugation Signup and view all the answers

Which component is collected at the bottom of the bowl during the processing of blood?

RBCs Signup and view all the answers

What happen to the oxygen transport property of recovered RBCs ?

equivalent to those of stored allogeneic RBCs. Signup and view all the answers

What is a potential risk associated with reinfusion of salvaged blood?

Air embolism Signup and view all the answers

What happens to the concentration of free hemoglobin in patients after receiving salvaged blood compared to allogeneic transfusion?

Increases slightly Signup and view all the answers

What is a limitation imposed on the quantity of recovered blood that may be reinfused without processing?

150 mm Hg vacuum limit Signup and view all the answers

What temperature range allows for up to 24 hours of storage for collected blood?

1-6°C Signup and view all the answers

salvaged blood compared with stored allogenic blood cells, which statement is true?

better oxygen-offloading capabilities in salvaged blood Signup and view all the answers

What potential complication is associated with infusing large volumes of washed or unwashed blood?

Disseminated intravascular coagulation (DIC) Signup and view all the answers

What is the purpose of employing microaggregate filters during reinfusion?

To prevent tissue debris and small blood clots from entering the patient's bloodstream Signup and view all the answers

What volume of collected blood is typically required to produce 225 to 250 mL of salvaged saline-suspended PRBCs?

500 to 700 mL Signup and view all the answers

What is the hematocrit (Hct) range of the salvaged PRBCs prepared for transfusion?

50% to 60% Signup and view all the answers

What capacity of banked blood can some systems provide to a massively bleeding patient through continual blood processing?

12 units/h Signup and view all the answers

when is contraindication for intraoperative blood collection ?

Application of procoagulant materials to the surgical field Signup and view all the answers

What measure can mitigate clinical infection risks related to recovered blood cultures?

Use of leukocyte filters in the system Signup and view all the answers

What percentage reduction in the need for allogeneic blood transfusion was observed in adult elective surgeries using intraoperative cell salvage?

38% Signup and view all the answers

In which type of surgeries was the greatest benefit of intraoperative blood salvage seen based on the text?

Orthopedic procedures Signup and view all the answers

What was the average amount of allogenic banked blood saved per patient through intraoperative blood salvage?

0.68 units Signup and view all the answers

Why do most programs set an upper limit on the volume of unprocessed blood that can be reinfused?

The presence of high concentrations of cytokines Signup and view all the answers

What happens if transfusion of postoperative shed blood is not initiated within 6 hours of collection?

The blood must be discarded Signup and view all the answers