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?

<p>Fluosol-DA (C)</p> Signup and view all the answers

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

<p>Causes microvascular vasoconstriction (B)</p> Signup and view all the answers

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

<p>Increased risk for myocardial infarction and death (C)</p> Signup and view all the answers

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

<p>Higher P50 value (A)</p> Signup and view all the answers

What is the role of HBOCs according to the text?

<p>Reserve for situations where RBC transfusion is not possible (A)</p> Signup and view all the answers

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

<p>Postoperative blood salvage (A)</p> Signup and view all the answers

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

<p>To decrease the severity of complications associated with allogenic transfusions (D)</p> Signup and view all the answers

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

<p>Hemoglobin level of no less than 11 g/dL (A)</p> Signup and view all the answers

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

<p>1 week (B)</p> 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?

<p>To allow restoration of intravascular volume and preparation of the donated blood (C)</p> 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?

<p>25 to more than 168 days (B)</p> 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?

<p>Increases by 24% (D)</p> Signup and view all the answers

Why are certain patient populations considered poor candidates for PAD?

<p>because of their underlying comorbidities (A)</p> Signup and view all the answers

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

<p>PAD donors have nearly 12 times the hospitalization rate of allogenic donors (A)</p> Signup and view all the answers

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

<p>Hb is 1.1 g/dL lower in PAD patients (C)</p> Signup and view all the answers

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

<p>Scheduled surgery to correct aortic stenosis (D)</p> Signup and view all the answers

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

<p>100 mL (D)</p> Signup and view all the answers

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

<p>Improves outcomes (D)</p> Signup and view all the answers

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

<p>Hip replacement surgery (D)</p> Signup and view all the answers

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

<p>Three-fourths fewer (B)</p> Signup and view all the answers

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

<p>Bronchoconstriction (C)</p> Signup and view all the answers

What protective effect does ANH have specifically during cardiac surgery?

<p>Prevents platelet dysfunction (D)</p> Signup and view all the answers

What should be considered when making decisions about using ANH?

<p>Patient's vital signs and blood volume (D)</p> Signup and view all the answers

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

<p>Reduced shedding of red blood cells during bleeding (B)</p> Signup and view all the answers

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

<p>To maintain the highest hemoglobin level in the reinfused blood (D)</p> 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?

<p>4°C for up to 24 hours (B)</p> 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?

<p>No notable differences have been observed (B)</p> Signup and view all the answers

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

<p>Collecting and reinfusing blood lost during surgery (D)</p> Signup and view all the answers

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

<p>Expected need for more than one unit of red blood cells (A)</p> Signup and view all the answers

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

<p>Heparin or Citrate (D)</p> Signup and view all the answers

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

<p>When the patient is unwilling to accept allogeneic blood (C)</p> Signup and view all the answers

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

<p>To reduce the need for allogenic blood transfusions (D)</p> Signup and view all the answers

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

<p>Patient anticipates a high volume of blood loss (D)</p> Signup and view all the answers

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

<p>Centrifugation (A)</p> Signup and view all the answers

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

<p>RBCs (D)</p> Signup and view all the answers

What happen to the oxygen transport property of recovered RBCs ?

<p>equivalent to those of stored allogeneic RBCs. (A)</p> Signup and view all the answers

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

<p>Air embolism (A)</p> Signup and view all the answers

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

<p>Increases slightly (A)</p> Signup and view all the answers

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

<p>150 mm Hg vacuum limit (B)</p> Signup and view all the answers

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

<p>1-6°C (D)</p> Signup and view all the answers

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

<p>better oxygen-offloading capabilities in salvaged blood (B)</p> Signup and view all the answers

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

<p>Disseminated intravascular coagulation (DIC) (B)</p> Signup and view all the answers

What is the purpose of employing microaggregate filters during reinfusion?

<p>To prevent tissue debris and small blood clots from entering the patient's bloodstream (B)</p> 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?

<p>500 to 700 mL (A)</p> Signup and view all the answers

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

<p>50% to 60% (B)</p> Signup and view all the answers

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

<p>12 units/h (C)</p> Signup and view all the answers

when is contraindication for intraoperative blood collection ?

<p>Application of procoagulant materials to the surgical field (B)</p> Signup and view all the answers

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

<p>Use of leukocyte filters in the system (B)</p> 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?

<p>38% (A)</p> Signup and view all the answers

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

<p>Orthopedic procedures (C)</p> Signup and view all the answers

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

<p>0.68 units (C)</p> Signup and view all the answers

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

<p>The presence of high concentrations of cytokines (A)</p> Signup and view all the answers

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

<p>The blood must be discarded (D)</p> Signup and view all the answers

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