This document provides an overview of blood transfusions for veterinary technicians. It discusses blood typing for canines and felines, the cross-matching process, transfusion set-up including equipment and monitoring, and various blood products including whole blood, packed red blood cells, plasma, oxyglobin, and albumin. Proper handling, storage, and administration techniques are covered for each product. Close patient monitoring during and after transfusions is emphasized due to risks of transfusion reactions.

1. Blood Transfusion for the
Veterinary Technician
Dawn Sadowski, CVT
November 3, 2013

2. Blood Transfusions
I will be talking about the following today:
1. blood typing and cross-matching
2. administration protocol
3. types of products available with their
basic uses, their storage and handling and
the product preparation.

3. Blood Typing

4. Canine Blood Typing
•
•
•
8 recognized DEA systems in canines.
DEA 1.1 is considered most important
They are either Negative or Positive

5. Feline Blood Typing
•
3 recognized blood types A, B and AB
•
Cats have naturally occurring
alloantibodies against type A or B cells,
depending on their own type.

6. Feline Blood Typing
•
•
It is critical to blood type all feline donors
and recipients
Can have a reaction to their first
transfusion

7. Cross-matching

8. Cross-matching
•
Required for all recipients except those
who have received a transfusion for the
first time in the past 4-5 days or recipients
that have never received any type of
transfusion.

9. Transfusion Set-up

10. Transfusion Set-up
•
Aseptic technique is very
important
•
All the transfusion products
are susceptible to
contamination

11. Transfusion Set-up
•
•
Keep system closed
during entire time of
administration.
Keep the lines off the
floor

12. Transfusion Set-up
•
•
•
Select the appropriate type of infusion set
for the product being administered
Here at IVG we use 3 different types of
filters.
Select the appropriate infusion pump for
the product being used

13. Transfusion Set-up
•
Blood Set

14. Transfusion Set-up
•
Blood Set

15. Transfusion Set-up
•
Hemo-nate filters

16. Transfusion Set-up

17. Transfusion Set-up
1. Handle with Care
2. Open infusion set
package
3. Peel open port to be
used on the product
4. Insert infusion set into
port on bag

18. Transfusion Set-up
5. Allow product to flush through
the infusion set, clamp
when hits the end
6. Feed into infusion pump
7. Connect to recipient at closest
port to recipient

19. Transfusion Set-up
8. Follow directions on Transfusion
monitoring worksheet.

20. Transfusion Set-up

21. Patient Monitoring

22. Patient Monitoring
•
•
•
It is extremely important that all patients
be closely monitored with all transfusions
Monitor vitals and demeanor of patient
Notify doctor with all changes

23. Patient Monitoring
•
The signs can include weakness,
trembling, restlessness, jaundice,
vomiting, drooling, edema, hives,
itchiness, incontinence, tachycardia,
fever, neurological signs, cardiac
arrhythmias, dyspnea, hypotension,
anaphylactic shock, disseminated
intravascular coagulation (DIC), and
death.

24. Patient Monitoring
•
•
Transfusion reactions can be either
immunologic or non-immunologic and
they can look the same. Both can be fatal.
If a patient shows any symptoms of a
reaction, stop the transfusion and notify a
doctor at once.

25. Products Regularly Available
1. Whole blood
2. Packed RBC
3. Fresh Frozen Plasma/Frozen Plasma
4. Oxyglobin
5. Canine Albumin/Human Albumin

26. Whole Blood

27. Whole Blood
•
Whole blood contains red blood cells,
plasma proteins, coagulation factors,
white cells and platelets.

28. Whole Blood
•
In whole blood transfusions –
contrary to popular belief
there are very few platelets
that actually make it to the
patient in the transfusion.

29. Whole Blood
•
A blood administering set that is
appropriate to size of bag is
recommended for transfusing whole
blood.

30. Whole Blood
•
A specialized infusion pump is
recommended with whole blood
transfusion so does not crush the cells

31. Packed Red Blood Cells

32. Packed Red Blood Cells
•
•
Only contain red blood
cells
Result of centrifugation
or sedimentation of a unit
of whole blood

33. Packed Red Blood Cells
•
•
Red cells are living cells
that require fresh oxygen
and carbon dioxide diffusion
in and out of each bag.
Storage can vary between
3-6 weeks

34. Packed Red Blood Cells
•
•
The advantage to pRBC is
that the volume is low and
the PCV is higher than
normal blood.
It is indicated for anemia

35. Packed Red Blood Cells
•
•
The disadvantage is it does not
contain plasma
It is contraindicated in cases
involving cardiac disease, renal
disease or animals without a
decreased hematocrit.

36. Packed Red Blood Cells
•
•
Warm pRBC to body
temperature before
administering
Administer using an aseptic
technique and keep closed
at all times

37. Packed Red Blood Cells
•
•
Use a blood administer set
appropriate to size of bag.
Use with an infusion pump
made for administering
blood such as a heska
pump

38. Packed Red Blood Cells

39. Frozen Plasma

40. Frozen Plasma
•
FP should be monitored closely. It is
recommended to use an indoor/outdoor
thermometer.

41. Frozen Plasma
•
•
Plasma is frozen in a
horizontal position then
stored upright.
Before using the plasma
check bag for any cracks
or signs of premature
thawing

42. Frozen Plasma
•
The frozen bags need
to be handled carefully
to avoid cracking and
causing contamination
during the thawing
process.

43. Frozen Plasma
•
•
Here at BVH we thaw the plasma
slowly in a bowl of luke warm
water.
The FP is placed in a sealed zip
lock bag before placing in the water
to prevent contamination.

44. Frozen Plasma
•
•
Administer with an appropriate sized
blood set or micro filter
Any infusion pump can be used with
plasma

45. Canine Fresh Frozen Plasma

46. Canine Fresh Frozen Plasma
•
Fresh frozen plasma is the
liquid component of whole
blood that has been
separated by centrifugation
and subsequently frozen
within 6-8 hours of collection

47. Canine Fresh Frozen Plasma
•
•
FFP is used to treat a variety of inherited
or acquired coagulopathies and
hemostatic disorders.
This includes the treatment of hemophilia
A and B, anticoagulant rodenticide
toxicities, von Willebrand disease and
other factor deficiencies.

48. Canine Fresh Frozen Plasma
•
It is also used to treat
hypoproteinemia caused by
multiple disease processes
such as pancreatitis, protein
losing enteropathies and
protein losing nephropathies,
DIC, sepsis and hepatic
failure.

49. Canine Fresh frozen Plasma
•
•
It has a shelf life of 1
year
Once stored for 1 year,
the unit should be
pulled and relabeled as
frozen plasma and
stored for an additional
4 years.

50. Canine Frozen Plasma

51. Canine Frozen Plasma
•
•
Canine frozen plasma is the expired FFP
with a shelf life of 4 years or
It is plasma that was collected but not
completely frozen within the 8 hour time
requirement to label it is as FFP.

52. Canine Frozen Plasma
•
•
FP is effective in the treatment of
acquired deficits of non-labile coagulation
factors.
It can also treat shock and
hypoproteinemic states.

53. Feline Frozen Plasma

54. Feline Frozen Plasma
•
•
A unit of Feline Frozen Plasma is
obtained by the centrifugation or
sedimentation of feline whole blood.
It is prepared at any time up to 5 days
after the expiration date applicable to the
original unit of whole blood.

55. Feline Frozen Plasma
•
A viable source of the other
components of plasma
such as albumin, globulins,
electrolytes and the
replacement of fluid
volume.

56. Feline Frozen Plasma
•
Thawed plasma is used for the
parental replenishment of non-labile
coagulation factors, albumin,
globulins, electrolytes and fluid
volume of the patient.

57. Oxyglobin

58. Oxyglobin
•
•
Is stored in its own foil wrap
which acts as an air barrier.
Once the foil is opened
oxyglobin must be used
within 24hrs.
It comes in 60ml or 125ml
single use bags

59. Oxyglobin
•
Oxyglobin is an oxygen carrying colloid
fluid made from bovine hemoglobin. It can
be used instead of pRBC’s when oxygen
capacity is needed.

60. Oxyglobin
•
In healthy animals,
hemoglobin within
red blood cells pick
up oxygen from the
lungs and deposits it
in the tissues via the
capillary
microcirculation.

61. Oxyglobin
•
Oxyglobin is used to treat anemia in dogs
by increasing the systemic oxygen
content and improving the clinical signs
associated with anemia.

62. Oxyglobin
•
Contraindicated in dogs with a
predisposition to volume overload such as
those with advanced cardiac disease or
otherwise severely cardiac function or
oliguria or anuria.

63. Oxyglobin
•
•
Is approved for use
in dogs only,
although it has
been used in cats.
It can be used, off
label, in cats, but
they are easier to
fluid overload.

64. Oxyglobin
•
Has a very minimal risk of transfusion
reaction, therefore typing and
crossmatching is not needed.

65. Oxyglobin
•
•
•
Cleared quickly from the body
Beneficial effects last only 24-36 hours
It is a pigment and will cause
yellow/red/brown discoloration of mucous
membranes, sclera, urine and skin.

66. Oxyglobin
•
•
•
•
Handle aseptically – great
medium for bacterial growth
No need for a blood filter
Can use any infusion set
Administer through a central
line or peripheral vein only

67. Oxyglobin
•
•
Watch for circulatory overload when
administering
Close monitoring of CVP’s is
recommended during and immediately
after the infusion.

68. Albumin

69. Albumin
•
A protein that is
synthesized by a
normally functioning
liver. Inarguably, is
one of the most
important proteins in
the body.

70. Albumin
•
•
Is a highly soluble globular protein which
accounts for 75-80% of the colloid oncotic
pressure in healthy animals.
It is also a transport protein and binds
naturally occurring substances such as
bilirubin, fatty acids, hormones and some
therapeutic drugs.

71. Albumin
•
The interstitial pool
provides a large storage
vat from which to draw
during states of albumin
loss or decreased albumin
synthesis in order to
maintain colloid oncotic
pressure of the serum.

72. Albumin
•
It serves a key role in the maintenance of
colloid oncotic pressure, free radical
scavenging, mediator of coagulation,
transport of exogenous and endogenous
substrates, buffering of serum and
contributor to wound healing

73. Albumin
•
A wide variety of critical
illnesses can result in
and become
exacerbated by
hypoalbuminemia

74. Albumin
•
•
•
•
•
•
•
•
Pancreatitis
Heat induced illness
Pneumonia
Parvovirus enteritis
Sepsis
Prostatitis
Pyometra
Burn injuries

75. Albumin
•
•
Fresh Frozen Plasma can be ineffective
and inefficient for replenishing albumin
when values are low
FFP will increase serum albumin by only
0.5g/dL, if there are no ongoing losses.

76. Albumin
•
~50% serum total protein
•
80% serum colloid oncotic pressure
•
Both humans and animals with
hypoalbuminemia <2 g/dL will have
increased morbidity and mortality

77. Albumin
•
To administer use a
syringe pump,
sterile fluid bag or a
blood bag without
an anti-coagulant.

78. Albumin
•
Infusion set should either be a filtered
blood set or a standard infusion set with
an in-line filter such as a hemo-nate filter
attached

79. Albumin

80. Human Albumin

81. Human Albumin
•
•
•
Treatment of hypoalbuminemia
Decreased colloid oncotic pressure
As a potent colloid in the treatment of
hypotension

82. Human Albumin
•
•
Albumin is structurally homologous
across species.
It differs ~20% of its amino acid sequence

83. Human Albumin
•
•
•
Is available in 5% or 25% solutions
Can be stored at room temperature for up
to 3 years
They do not contain preservatives, should
be used within 4 hours of opening

84. Human Albumin
•
It is recommended to give
Diphenhydramine 15 minutes prior to
albumin administration

85. Canine Albumin

86. Canine Albumin
•
•
•
Stored at a controlled room temperature
or refrigerated temperature (34-80F)
Stable for 24months past expiration date
Once reconstituted it must be used within
6 hours