The most common clinical manifestation of a hemolytic transfusion reaction is:
All of the manifestations listed can occur with a hemolytic transfusion reaction. In a large series, oliguria (58%) and hemoglobinuria (56%) were the most common findings.
What type of bacterial sepsis can lead to thrombocytopenia and hemorrhagic disorder?
Lastly, severe hemorrhagic disorders due to thrombocytopenia have occurred as a result of gram-negative sepsis. The pathogenesis of endotoxin-induced thrombocytopenia has been suggested that a labile factor V is necessary for this interaction.
After tissue injury, the first step in coagulation is:
All the listed steps are part of the cascade involved in establishing a firm clot. The process begins with binding of Hageman factor (factor XII) to subendothelial collagen and ends with the conversion of fibrinogen to fibrin. The fibrin forms an insoluble addition that stabilizes the platelet plug.
What are the uses of thromboelastography (TEG)?
Thromboelastography (TEG) is the only test measuring all dynamic steps of clot formation until eventual clot lysis or retraction. TEG has also been shown to identify, patients who are likely to develop thromboembolic complications postinjury and postoperatively. Recent trauma data have shown TEG to be useful in predicting early transfusion of RBCs, plasma, platelets, and cryoprecipitate. TEG can also predict the need for lifesaving interventions shortly after arrival and to predict 24-hour and 30-day mortality. Lastly, TEG can be useful to guide administration of tranexamic acid to injured patients with hyperfibrinolysis.
Bank blood is appropriate for replacing each of the following EXCEPT:
Factor VIII is labile, and 60 to 80% of activity is gone 1 week after collection. The other factors listed are stable in banked blood.
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