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Transfusion Therapy and Collection Techniques for Blood Banking 1171

• Microembolism • Attach second anticoagulant-filled syringe, ○ Multiple transfusions
• Hypothermia and gently aspirate 27 mL of blood as already ○ Hypothermic animals
○ Neonates
described.
VetBooks.ir • Citrate toxicosis • Release jugular pressure. ○ Warm by room air or water bath (never
• Acidosis
• Remove needle from jugular vein.
microwave); place blood in waterproof bag
• Hyperammonemia (stored blood in patient
for water bath immersion.
with hepatic failure)
• NOTE: A similar technique can be used in
dogs (60-mL syringe with 7 mL ACD or ○ Do not exceed 37°C (hemolysis).
Procedure CPDA-1) if collection bags are unavailable; • FFP/frozen plasma, 10-20 mL/kg:
Blood collection for banking: blood donor dogs: refrigerate and use within 24 hours. ○ Plastic is fragile when frozen; handle frozen
• Administer butorphanol 0.2 mg/kg IV. Transfusion of blood products: units delicately.
• Place in lateral recumbency on an elevated • For all blood products ○ Thaw in 37°C water bath in a waterproof
surface. ○ Always use a filter. plastic bag.
• Clip ventral neck (center over jugular ○ Start slowly (0.5 mL/kg/h) for 15-20 ○ Give within 4 hours for clotting factors.
furrow). minutes. ○ Can store 24 hours in refrigerator after
• Perform sterile scrub. ○ Monitor for reactions. thawing if clotting factors not required
• Place collection bag on the scale at a level ○ Increase rate if no reactions occur. ○ Repeat dosage if coagulopathy persists. Procedures and Techniques
below the animal (blood collects by gravity). ○ Complete transfusion by 4 hours (decreases
• Zero the scale (collection bag ± anticoagulant bacterial contamination). Postprocedure
≈85 g). ○ Typical rate is 5-10 mL/kg/h. • Blood donors: place neck wrap (for several
• NOTE: If less than 450 mL of blood is to be ○ Can increase to 20 mL/kg/h in unstable hours) to minimize hematoma formation.
collected, anticoagulant must be expressed hypovolemic animals Offer food and water. Administer fluids
from the collection bag to maintain the ○ Can administer as rapidly as possible in if hypovolemic (tachycardia, pale mucous
1 : 7 anticoagulant-to-blood ratio (e.g., to a crisis membranes, prolonged capillary refill time)
collect 225 mL blood, discard one-half of ○ For heart disease, renal failure, or potential or the fluid equivalent if more than 2% of
the anticoagulant [32 g]). volume overload, administer at 1-4 mL/ the body weight in kilograms is collected.
• Clamp tubing with hemostat (near needle). kg/h, and monitor for volume overload • Patients/recipients: check PCV 2 hours after
• Hold off jugular vein for visualization. (see above). the transfusion is complete. Check coagula-
• Remove needle cap and insert needle (16-17 ○ Can divide dosage into smaller aliquots tion profile after administering plasma for
gauge) into jugular vein. and refrigerate up to 24 hours (allows coagulopathies.
• Remove hemostat; collection begins. slower administration with minimal risk
• During collection, gently rock the bag inter- of bacterial contamination) Alternatives and Their
mittently to mix blood with anticoagulant. • From a syringe Relative Merits
• Rotate/adjust needle delicately if flow stops. ○ Attach syringe filter to syringe. • Polymerized hemoglobin (e.g., Oxyglobin):
• Continue collection until scale reads 450 g ○ Attach IV extension set to filter. ○ Improves oxygen delivery
(± 45 g). ○ Prime system with blood product. ○ Provides colloidal support but no other
• Release jugular vein pressure. ○ Connect extension set to IV catheter. plasma benefits
• Reclamp tubing near needle. ○ Use syringe pump or intermittent slow ○ Dogs: 10-30 mL/kg at a maximum of
• Remove needle from jugular vein. bolus administration (i.e., healthy cats: 10 mL/kg/h
• Carefully recap needle. 5 mL over 5 minutes, then wait 6-12 ○ Cats: 5-10 mL/kg at a maximum of 5 mL/
• Strip blood from tubing into bag to mix minutes and repeat). kg/h
with anticoagulant. • From a collection bag ○ Monitor closely for signs of volume
• Allow tubing to refill to prepare short segments ○ Use blood administration set with filter overload, especially in cats.
of tube with blood for later cross-match. (see manufacturer’s instructions). ○ Product has been on and then off
• Tie/hemoclip tubing at 6- to 10-cm ○ Prime administration set with blood the commercial market; may not be
intervals for storage and cross-match. This product. available
allows access to small blood sample without ○ Attach to IV catheter. • Colloids
penetrating stored blood bag. ○ Set drip rate. ○ Hypoalbuminemia requires large volumes
• Remove hemostat. ○ Some infusion pumps can be used; check of whole blood or plasma to correct.
• If collection technique is questionable, blood manufacturer specifications. ○ Synthetic colloids (dextrans, gelatins, and
should be used within 24 hours. • Dosages hydroxyethyl starches): controversial due
Blood collection for banking: blood donor cats: ○ Whole blood: 10-20 mL/kg to risk of acute kidney injury in people.
• Sedate (1-2 mg/kg ketamine IV; may add ■ Generally, 2 mL/kg increases PCV Still frequently used to support colloidal
diazepam 0.1 mg/kg IV if necessary). ≈1%. pressure in cats and dogs (bolus 5-20 mL/
• Clip ventral neck (center over jugular ○ PRBCs: 5-10 mL/kg kg, then 10-20 mL/kg/day; use lower
furrow). ■ Generally, 1 mL/kg increases PCV doses for cats).
• Perform sterile scrub. ≈1%. ○ Human albumin: role is controversial;
• Use a separate needle to put 4 mL ACD or ■ Can dilute with 50-125 mL 0.9% saline use with caution because fatal reactions
CPDA-1 into each sterile 35-mL syringe. to decrease viscosity reported. Suggested guidelines if used:
• Connect one 35-mL syringe to a butterfly ○ Alternatively, PRBCs or whole blood dogs, 2-7 mL/kg of 25% or 10-35 mL/
needle. (milliliters) dose = BW (kilograms) × 90 kg of 5% over 4-6 hours. Canine-specific
• Hold off jugular vein to visualize. × (PCV desired − PCV recipient)/PCV albumin may be safer, but studies are
• Remove needle guard. of donor blood; substitute 90 with 60 for lacking, and availability is limited. Dosage
• Insert butterfly needle into jugular vein. cats. is the same as for human albumin.
• Gently aspirate 27 mL of blood while slowly ○ Oncotic support • Lyophilized canine products
rocking the syringe to mix anticoagulant and ■ 45 mL/kg FFP generally increases serum ○ Lyophilized canine albumin has been
blood. albumin by 1 g/dL (10 g/L). used in hypoproteinemic dogs (Animal
• Disconnect syringe from butterfly catheter. • Warming whole blood or PRBCs is not Blood Resources International, Dixon,
• Cap syringe with a sterile needle. essential; indications to warm CA). Reconstitute 800 mg/kg with 0.9%

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