CCP Blood Conservation & Transfusion Strategies Flashcards

Fresh frozen plasma (FFP) is indicated post-CPB when:

Answer: PT/INR is significantly elevated with active microvascular bleeding

FFP contains all clotting factors and is indicated for coagulopathic bleeding with elevated PT/INR, not as a volume expander.

Cryoprecipitate is administered post-bypass primarily to replace:

Answer: Fibrinogen and factor VIII

Cryoprecipitate is enriched with fibrinogen, factor VIII, vWF, and factor XIII, making it the preferred product for fibrinogen replacement in coagulopathic bleeding.

Preoperative autologous donation (PAD) for elective cardiac surgery is currently:

Answer: Largely abandoned due to evidence of preoperative anemia induction with no clear benefit

PAD is no longer routinely recommended because donating blood preoperatively induces anemia that may offset any transfusion benefit, and trials have not shown improved outcomes.

Acute normovolemic hemodilution (ANH) works by:

Answer: Collecting whole blood at surgery start, replacing volume with crystalloid/colloid, then retransfusing after bypass

ANH collects whole blood before bypass and stores it at bedside under normothermic conditions; this fresh autologous blood, rich in clotting factors and platelets, is retransfused after bypass.

Point-of-care platelet function testing using devices such as the Multiplate analyzer helps guide:

Answer: Targeted platelet transfusion decisions in coagulopathic patients

Platelet function analyzers assess aggregation defects, helping clinicians determine whether platelet transfusion will address the source of bleeding versus other factor deficiencies.

Protamine administration after CPB can cause which of the following serious adverse effects?

Answer: Systemic hypotension and pulmonary hypertension

Protamine can trigger systemic hypotension, pulmonary hypertension, and anaphylactoid reactions, particularly in patients with fish allergies or prior protamine or insulin exposure.