Haemostatic Agents – Packed Red Blood CellsBy Charles 3 Haemostatic Agents – Packed Red Blood Cells (QID7) EACCME quiz to follow Webinar Lecture focused on. Haemostatic Agents: Packed Red Blood Cells 1 / 13 RBCs Transfusion improves tissue oxygenation and microcirculation in ICU patients: If it is administered at the hemoglobin trigger value of 10 g/dl In patients with abnormal tissue oxygenation and/or microcirculatory indices prior to transfusion If it is administered using a hemoglobin trigger value of 9 g/dl If it is administered using as trigger a hematocrit value less than 30% 2 / 13 The results of the TRICC trial ( a multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care) showed that: Outcome was better if RBCs transfusion was given at a hemoglobin trigger of 10 g/dl In younger patients (less than 55 years of age) outcome was better if they received transfusion at a hemoglobin trigger of 10 g/dl Restrictive transfusion was non inferior to liberal transfusion strategy Restrictive transfusion strategy did not result in the reduction of the number of packed RBCs used 3 / 13 According to the World Health Organization (WHO), anemia is defined for women by a hemoglobin level less than: 13 g/dl 12 g/dl 10 g/dl 7 g/dl 4 / 13 In critically ill patients, which of the following sentences is false? Iron administration should be discontinued if there is evidence of iron overload (serum ferritin ≥1000 ng/mL or transferrin saturation ≥50%) Intravenous iron administration should be avoided in the setting of acute infection, especially in sepsis. Low reticulocyte hemoglobin concentration is usually found in iron-deficiency anemia Oxygen delivery to the tissues is not influenced by the hemoglobin level 5 / 13 In critically ill patients, which of the following sentences is false? Iron administration should be discontinued if there is evidence of iron overload (serum ferritin ≥1000 ng/mL or transferrin saturation ≥50%) Intravenous iron administration should be avoided in the setting of acute infection, especially in sepsis. Low reticulocyte hemoglobin concentration is usually found in iron-deficiency anemia Oxygen delivery to the tissues is not influenced by the hemoglobin level 6 / 13 The results of the TRICC trial ( a multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care) showed that: In less severe patients (APACHE score <20 points), survival was better if RBCs transfusion was given at a hemoglobin trigger of 10 g/dl In younger patients (less than 55 years of age) outcome was better if they received transfusion at a hemoglobin trigger of 10 g/dl Restrictive transfusion was non inferior to liberal transfusion strategy Restrictive transfusion strategy did not result in the reduction of the number of packed RBCs used 7 / 13 Which of the following sentences is true? Anemia is rarely seen in ICU patients An increase in serum Soluble transferrin receptors concentration is a sensitive and quick response to the development of iron deficiency In the absence of inflammation, plasma ferritin concentration is high in iron deficiency anemia Normally the largest amount of oxygen is carried in blood dissolved in plasma and only a very small amount is bound to hemoglobin 8 / 13 Which of the following sentences is true? Anemia is rarely seen in ICU patients An increase in serum Soluble transferrin receptors concentration is a sensitive and quick response to the development of iron deficiency In the absence of inflammation, plasma ferritin concentration is high in iron deficiency anemia Normally the largest amount of oxygen is carried in blood dissolved in plasma and only a very small amount is bound to hemoglobin 9 / 13 In the postoperative setting, which one of the following sentences is correct? Iron deficiency anemia is diagnosed by ferritin concentration < 100 µg/l or ferritin < 100–300 µg/l and TSAT <20% Iron deficiency anemia can be revealed by increased reticulocyte hemoglobin content (higher than 28 pg) In the postoperative period, when the administration of iron is necessary, oral iron therapy is preferred instead of intravenous formulations The correction of iron deficiency-anemia can only be performed preoperatively and cannot be recommended in the postoperative setting 10 / 13 In the postoperative setting, which one of the following sentences is correct? Iron deficiency anemia is diagnosed by ferritin concentration < 100 µg/l or ferritin < 100–300 µg/l and TSAT <20% Iron deficiency anemia can be revealed by increased reticulocyte hemoglobin content (higher than 28 pg) In the postoperative period, when the administration of iron is necessary, oral iron therapy is preferred instead of intravenous formulations The correction of iron deficiency-anemia can only be performed preoperatively and cannot be recommended in the postoperative setting 11 / 13 In the postoperative setting, which one of the following sentences is correct? Iron deficiency anemia is diagnosed by ferritin concentration < 100 µg/l or ferritin < 100–300 µg/l and TSAT <20% Iron deficiency anemia can be revealed by increased reticulocyte hemoglobin content (higher than 28 pg) In the postoperative period, when the administration of iron is necessary, oral iron therapy is preferred instead of intravenous formulations The correction of iron deficiency-anemia can only be performed preoperatively and cannot be recommended in the postoperative setting 12 / 13 Regarding the effects of inflammation on the plasma concentrations of iron-binding proteins, which of the following sentences is true? Ferritin has a rapid decrease with onset of inflammation Transferrin decreases with onset of inflammation Haptoglobulin decreases with onset of inflammation Soluble transferrin receptors exhibit an important and rapid increase with onset of inflammation 13 / 13 Which of the following sentences is true? Compared to SD Plasma (Solvent detergent plasma), in FFP the concentration of proinflammatory mediators is higher The risk of TRALI is higher with SD plasma compared to FFP The risk of allergic reactions is higher with SD plasma compared to FFP Transfusion of FFP always results in a significant decrease of INR value Your score is
