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Apheresis book 1

chapter 1

QuestionAnswer
When a tube of blood is centrifuged, the components separate in order of increasing specific gravity: list top to bottom plasma, platelets, lymphocytes and monocytes, granulocytes, RBCs
Typical preset ratio for anticoagulant solution in apheresis 10-14 parts of whole blood to 1 part of citrate Anti-coagulant
Which is more commonly used for apheresis procedures: A. centrifugation B. filtration A. centrifugation
The most commonly performed therapeutic apheresis procedure TPE: therapeutic plasma exchange
What % of IgM is removed with a 1 volume TPE? 70%; IgG is less
Increased muscle mass effects total blood volume in this way increases
obesity effects total blood volume in this way decreases
formula for estimating total blood volume 70ml/kg in males; 65 ml/kg in females
The general standard of care is to limit the extracorporeal blood volume during an apheresis procedure to this % 15%
for TPE, avoid using plasma unless: 1._ 2._ 3._ 1. plasma is specifically indicated to treat disease(TTP) 2. plasma is required to correct a coagulation factor 3. plasma is needed to prevent dilutional coagulopathy in actively bleeding patient (pulmonary renal syndrome)
When a patient needs dialysis and apheresis the same day, which should be done first? Why? apheresis because possible hypotension
anticoagulant of choice in apheresis citrate
how does citrate work as an anticoagulant binds calcium. blocks calcium dependent platelet activation and clotting factor reactions
Patients with dysfunction in this organ are more prone to citrate reactions in apheresis liver
The single greatest risk factor for adverse events associated with therapeutic apheresis central venous catheter
Apheresis effect on PT and PTT increases
This coagulation protein should be assessed regularly in TPE patients fibrinogen
The rate of adverse events during therapeutic apheresis is _% 5% (up to 33% if you count mild perioral tingling,etc)
Most common symptoms of citrate reactions perioral tingling and peripheral parethesias
treatments for citrate reactions lower rate. tums. IV calcium gluconate
The most common reaction seen with whole blood donation vasovagal reaction
Treatment of air embolism place patient on left side in Tredenlenberg position so air will go to apex of right ventricle. Then air will dissolve into bloodstream
Created by: jfshikle