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==Production of Blood Products==
[[File:production of blood products.jpg|thumb|right|300px|<p>'''Production of Blood Products''' (2010)]]
Whole fresh blood is commonly used in general practice and administered straight away to the patient. Additionally whole blood can be stored or separated into various blood components.
These components are very useful as they reduce the number of transfusions necessary and also replace specific losses.
If fresh whole blood undergoes <u>slow</u> centrifugation (1100tr/min for 10 mins at 22 <sup>o</sup> C) then '''Platelet rich plasma''' is produced. This can be stored for 3 days at an ambient temperature.
If fresh whole blood undergoes <u>fast</u> centrifugation (2500tr/min for 20 mins at 5 <sup>o</sup> C then both [[Plasma|plasma]] and [[Erythrocytes|red blood cells]] become separated. '''Red blood cells''' can then be stored at 2-6<sup>0</sup>C for 4 weeks. Fresh '''plasma''' must be used in the 6 hours following production unless it is frozen at -20<sup>o</sup>C where it becomes '''fresh frozen plasma''' and can then be stored and used for the next 2 years.
==Types of Blood products available==
==Types of Blood products available==
Whole fresh blood is commonly used in general practice and administered straight away to the patient. Additionally whole bood can be stored or separated into various blood components for example, Packed red blood cells, plasma and platelet rich concentrates.
'''Fresh Whole Blood (FWB)''' can be [[Administering a Blood Transfusion|collected]] from a healthy donor and combined with anticoagulant which can then be used for up to 8 hours. Whole blood contains all blood components which are [[Erythrocytes|Red blood cells]], [[Thrombocytes|Platelets]], [[Leukocytes|White blood cells]], Coagulation factors and plasma proteins. This is indicated for for dogs and cats suffering from [[:Category:Anaemia|anaemia]], thrombocytopaenia or a [[Coagulation Defects|coagulopathy]] with active bleeding.
'''Fresh Whole Blood (FWB)''' can be [[Blood Collection for Transfusion |collected]] from a healthy donor and combined with anticoagulant which can then be used for up to 8 hours. Whole blood contains all blood components which are [[Erythrocytes|Red blood cells]], [[Thrombocytes|Platelets]], [[Leukocytes|White blood cells]], Coagulation factors and plasma proteins. This is indicated for for dogs and cats suffering from anaemia, thrombocytopaenia or a coagulopathy with active bleeding.
'''Stored Whole blood (SWB)''' is FWB collected and stored at 2-6 <sup>o</sup> C and can be used for up to 4 weeks. It can be useful for patients requiring red blood cells and plasma proteins as the other components will no longer be viable. This can be used to treat anaemic patients who are hypovolaemic.
'''Stored whole blood (SWB)''' is WHB collected and stored and can be used for up to 28 days. It can be useful for patients requiring red blood cells and plasma proteins as the other components will no longer be viable. This can be used to treat anaemic patients who are hypovolaemic.
'''Packed Red Blood Cells''' containing only red blood cells are given to patients suffering from anaemia but who are normovolaemic to provide additional oxygen carrying cells.
'''Packed Red Blood Cells''' containing only red blood cells are given to patients suffering from anaemia but who are normovolaemic to provide additional oxygen carrying cells.
'''Fresh Plasma''' contains plasma proteins and coagulation factors. Its use is indicated in patients with Von Willebrand's disease, Haemophilia A ad B, [[Disseminated Intravascular Coagulation|Disseminated Intravascular Coagulation]], other [[Coagulation Factor Deficiency|coagulation factor deficiencies]], hypoproteinaemia, acute [[Pancreatitis|pancreatitis]] and systemic inflammatory response syndrome.
'''Fresh Frozen Plasma (FFP)''' contains coagulation factors and plasma proteins. It can be stored at -20 oC for up to a year. Its use is indicated in patients with Von Willebrand's disease, Haemophilia A ad B, [[Disseminated Intravascular Coagulation|Disseminated Intravascular Coagulation]], other [[ Coagulation Factor Deficiency|coagulation factor deficiencies]], hypoproteinaemia, acute [[Pancreatitis - Dog and Cat|pancreatitis]] and systemic inflammatory response syndrome.
'''Fresh Frozen Plasma (FFP)''' contains coagulation factors and plasma proteins. Its indications are the same as fresh plasma.
'''Cryoprecipitate''' contains Von Willebrands Factor, Factor VIII and XII, fibrinogen, and fibronectin. It is the blood product of choice in the treatment of Von Willebrands disease, Haemophilia A and hypofibrinogenaemia. Cryoprecipitate can be stored for one year after collection.
'''Cryoprecipitate''' is produced from FFP that has been thawed slowly and then centrifuged at 5000RPM for 5mins at 4<sup>o</sup>C. The plasma is then removed leaving a small amount of cryo. It contains Von Willebrands Factor, Factor VIII and XII, fibrinogen, and fibronectin. It is the blood product of choice in the treatment of Von Willebrands disease, Haemophilia A and hypofibrinogenaemia. Cryoprecipitate can be stored for one year after collection.
'''Oxyglobin'''is a very useful blood product as it increases plasma haemoglobin concentration. It can be used in the dog but its use in the cat is not licensed. It's use in indicated in cases of severe anamia of any cause.
'''Oxyglobin''' is a very useful blood product as it increases plasma haemoglobin concentration. It is produced from bovine haemoglobin and is licensed for use in the dog but not for the cat. Oxyglobin is indicated in cases of severe anaemia of any cause.
When recieving oxyglobin patients should be monitored for the development of circulatory overload.
When receiving oxyglobin, patients should be monitored for the development of circulatory overload.
'''Xenotransfusion''' can be performed by giving dog blood to cats. There are no naturally occurring antibodies, however cells do not last as long as properly matched ones. They will form antibodies within ~4 days afterwards.
==Administration of Blood products==
==Administration of Blood products==
Are normally administered intravenously however if this is not possible then the intraosseous route can be used. Plasma products need to be thawed prior to administration, red blood cell products can normally be given straight away. An in-line filter is required for all blood products.
Pre-treatment with an anti-histamine SQ is typically standard (2mg/kg Diphenhydramine, 0.5mg/kg Chlorphineramine).
The rate the transfusion should be administered also varies but generally can be started at 0.25-1.0ml/kg for the first 20 minutes and can then be increased if no problems are encountered.
Or:
0.5mls/kg 1st 15 min
1ml/kg 2nd 15 min
Total volume to be delivered over the next 4 hours to avoid bacterial growth.
Signs of a reaction include: spike in temperature, panting, elevated HR, collapse, vomiting, diarrhea, pale gums.
Maximum rate is 5mls/kg/hr in most cases but can be given at 10ml/kg/hr in an emergency
The amount of product to give will vary on the patient's state, the product being used and the response to the product.
The amount of product to give will vary on the patient's state, the product being used and the response to the product.
Generally the PCV will increase by 1% for every 10-22ml/kg administered.
Generally the [[Packed Cell Volume|PCV]] will increase by 1% for every 1ml/kg of body weight for pRBC given or 1% for every 1ml/lb of whole blood given.
{| cellpadding="10" cellspacing="0" border="1"
| See also:
|'''[[Indications for Blood Transfusions]]<br>[[Administering a Blood Transfusion]]<br>[[Blood Groups|Blood Groups]]<br>[[Blood Groups - Dog|Blood Groups - Dog ]]<br>[[Blood Groups - Cat|Blood Groups - Cat ]]<br>'''
|}
==References==
==References==
Transfusion Therapy. Lymphoreticular and Haematology module. 4th year notes. Royal Veterinary College London. 2009.
Transfusion Therapy. Lymphoreticular and Haematology module. 4th year notes. Royal Veterinary College London. 2009.
'''Selected Topics in Canineand Feline Emergency Medicine'''. Volume 1. Handbook for the veterinary practitioner. ''Royal Canin''.
'''Selected Topics in Canine and Feline Emergency Medicine'''. Volume 1. Handbook for the veterinary practitioner. ''Royal Canin''.
[[Category:Transfusion Medicine]]
[[Category:Transfusion Medicine]]