56 Questions
What is the main advantage of Hb-based O2 carriers (HBOCs) over human blood?
Do not require type and crossmatch
Which perfluoro compound carries three to four times more oxygen than Fluosol-DA?
Perfluorooctyl bromide
What characteristic is required by most HBOCs to prevent nephrotoxicity?
Stroma-free Hb
Which synthetic blood product was initially approved for perfusion of ischemic tissues?
Fluosol-DA
What is the main issue with stroma-free Hb as mentioned in the text?
Causes microvascular vasoconstriction
What was a significant finding of Natanson and colleagues' meta-analysis on HBOCs?
Increased risk for myocardial infarction and death
What distinguishes Hemopure (HBOC-201) from human RBCs based on the text?
Higher P50 value
What is the role of HBOCs according to the text?
Reserve for situations where RBC transfusion is not possible
What is one of the distinct procedures that autologous blood transfusion constitutes, according to the text?
Postoperative blood salvage
What is one of the aims of autologous transfusion mentioned in the text?
To decrease the severity of complications associated with allogenic transfusions
What criterion must most donors meet prior to preoperative autologous donation according to the AABB?
Hemoglobin level of no less than 11 g/dL
What is the recommended time interval between repeated donations for preoperative autologous donation?
1 week
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
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
What is the effect of preoperative autologous donation (PAD) on the risk of receiving a transfusion from any source?
Increases by 24%
Why are certain patient populations considered poor candidates for PAD?
because of their underlying comorbidities
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
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
which one is considered Contradictions to Participation in Autologous Blood Donation Programs
Scheduled surgery to correct aortic stenosis
How much RBC mass is saved by minimal ANH compared to a patient's blood volume?
100 mL
What do retrospective data suggest about the impact of even mild ANH?
Improves outcomes
In which type of surgeries has ANH been shown to decrease transfusion requirements according to randomized trials?
Hip replacement surgery
How many allogenic blood units were patients who underwent ANH receiving compared to control groups on average?
Three-fourths fewer
What potential complication was observed in adult animal models receiving ANH transfusions?
Bronchoconstriction
What protective effect does ANH have specifically during cardiac surgery?
Prevents platelet dysfunction
What should be considered when making decisions about using ANH?
Patient's vital signs and blood volume
What is the major benefit of Acute Normovolemic Hemodilution (ANH) mentioned in the text?
Reduced shedding of red blood cells during bleeding
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
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
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
What does the term 'intraoperative cell salvage' refer to?
Collecting and reinfusing blood lost during surgery
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
Which anticoagulants are commonly used in the blood collection process of cell salvage?
Heparin or Citrate
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
What is one of the main purposes of intraoperative cell salvage during surgery?
To reduce the need for allogenic blood transfusions
Which scenario would make a patient a good candidate for cell salvage?
Patient anticipates a high volume of blood loss
What process separates the lower density plasma and anticoagulant fluid from the higher density RBCs in processing?
Centrifugation
Which component is collected at the bottom of the bowl during the processing of blood?
RBCs
What happen to the oxygen transport property of recovered RBCs ?
equivalent to those of stored allogeneic RBCs.
What is a potential risk associated with reinfusion of salvaged blood?
Air embolism
What happens to the concentration of free hemoglobin in patients after receiving salvaged blood compared to allogeneic transfusion?
Increases slightly
What is a limitation imposed on the quantity of recovered blood that may be reinfused without processing?
150 mm Hg vacuum limit
What temperature range allows for up to 24 hours of storage for collected blood?
1-6°C
salvaged blood compared with stored allogenic blood cells, which statement is true?
better oxygen-offloading capabilities in salvaged blood
What potential complication is associated with infusing large volumes of washed or unwashed blood?
Disseminated intravascular coagulation (DIC)
What is the purpose of employing microaggregate filters during reinfusion?
To prevent tissue debris and small blood clots from entering the patient's bloodstream
What volume of collected blood is typically required to produce 225 to 250 mL of salvaged saline-suspended PRBCs?
500 to 700 mL
What is the hematocrit (Hct) range of the salvaged PRBCs prepared for transfusion?
50% to 60%
What capacity of banked blood can some systems provide to a massively bleeding patient through continual blood processing?
12 units/h
when is contraindication for intraoperative blood collection ?
Application of procoagulant materials to the surgical field
What measure can mitigate clinical infection risks related to recovered blood cultures?
Use of leukocyte filters in the system
What percentage reduction in the need for allogeneic blood transfusion was observed in adult elective surgeries using intraoperative cell salvage?
38%
In which type of surgeries was the greatest benefit of intraoperative blood salvage seen based on the text?
Orthopedic procedures
What was the average amount of allogenic banked blood saved per patient through intraoperative blood salvage?
0.68 units
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
What happens if transfusion of postoperative shed blood is not initiated within 6 hours of collection?
The blood must be discarded
Explore the world of synthetic oxygen-carrying substances in medicine, particularly focusing on Hb-based oxygen carriers (HBOCs) as alternatives to human blood transfusions. Learn about the advantages of HBOCs and the dominant approaches in developing synthetic blood products.
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