A 68-year-old man has signs of a coagulopathy after receiving 10 units of packed erythrocytes during emergency repair of a leaking abdominal aortic aneurysm. The most likely cause is
Following transfusion of packed red blood cells during general anesthesia, the patient's blood pressure decreases, heart rate and temperature increase, and hemoglobinuria and diffuse oozing are observed. Which of the following is the most appropriate first step in management?
Fresh frozen plasma is indicated in each of the following situations EXCEPT
A 60-year-old obese man who has an antithrombin III deficiency is scheduled for radical prostatectomy. Prior to the operation this patient should receive
The most common transfusion-related infection is
The most common clinical viral infection following homologous blood transfusion is caused by
Which of the following findings is characteristic of whole blood preserved in CPD and stored at 4°C for one week?
Which of the following statements concerning the risk of acquiring hepatitis from a blood transfusion is true?
A normotensive 66-year-old man undergoes total hip arthroplasty. Mean arterial pressure is maintained at 60 mmHg with isoflurane and labetalol; intraoperative FiO2 is 1.0. Eight units of red blood cells are administered intraoperatively because of an injury to the femoral artery. Five days later, the patient develops jaundice. Which of the following is the most likely cause of the jaundice?
A patient becomes flushed, dyspneic, and hypotensive during transfusion of 1 unit of packed red blood cells in the PACU. After discontinuing the transfusion, the most appropriate next step is administration of
An otherwise healthy 70-year-old man receives 12 units of packed red blood cells for persistent diffuse bleeding during suprapubic prostatectomy. Hemoglobin concentration is 11 g/dL, platelet count is 55,000/mm3, plasma fibrinogen concentration is 180 mg/dL, protime is 14 sec, and partial thromboplastin time is 35 sec. The most appropriate therapy is administration of
An advantage of CPDA-1 over CPD for storage of packed red blood cells is
An 8-kg, 1-year-old child has a measured blood loss of 50 ml during the first two hours of a rectal pull-through operation. Preoperative hematocrit was 31%. Balanced saline solution 150 ml has been administered for replacement. Urine output has been 2 ml for the last hour, heart rate is 160 bpm, and blood pressure is 40/15 mmHg. The most appropriate fluid therapy is,
A patient develops urticaria and pruritus while receiving a blood transfusion in the PACU. Blood pressure and heart rate are unchanged from pretransfusion values. The most appropriate action is administration of
Each of the following indicates a hemolytic transfusion reaction in an anesthetized patient EXCEPT
Which of the following is an indication for administration of fresh frozen plasma?
A 70-kg patient with no acute bleeding has a preoperative platelet count of 40,000/mm3. Following preoperative transfusion of platelets 10 units, the predicted platelet count would be
A 35-year-old woman undergoes a one-hour abdominal liposuction procedure under general anesthesia. During the procedure, 2000 ml of crystalloid is administered and 800 ml of fatty tissue is extracted. Thirty minutes postoperatively, blood pressure is 75/40 mmHg and heart rate is 100 bpm; SpO2 is 94% on room air. Which of the following is the most likely cause of these findings?
A 27-year-old man with type I von Willebrand's disease requires internal fixation of an open fracture of the femur. Prothrombin time, partial thromboplastin time, and platelet count are normal. During surgery, there is significant oozing from the wound and the surgeon notes poor clot quality. The most appropriate therapy at this time is administration of
During a reoperative total hip arthroplasty requiring transfusion of 8 units of packed red blood cells, blood begins to ooze from the operative field and intravenous catheter sites. Urine is pink. The most likely cause is
Diffuse microvascular bleeding is noted in a patient who has received 25 units of whole blood for a liver resection. Platelet count is 40,000/mm3, prothrombin time is 18 sec, activated partial thromboplastin time is 54 sec, and serum fibrinogen concentration is 60 mg/dl. The most likely cause of the bleeding is
A 54-year-old woman who is scheduled to undergo emergency exploratory laparotomy takes warfarin sodium for anticoagulation. Prothrombin time is 19 sec (control 12 sec). Which of the following agents is most appropriate to reverse the effects of warfarin?
During laparotomy for a ruptured spleen, unexplained oozing occurs after infusion of 2 liters of crystalloid and 3 units of blood. The most likely cause is
An unvaccinated health care worker is stuck by a needle contaminated with blood from an HBsAg-positive patient. Which of the following statements concerning this situation is true?
An 8-kg, 5-month-old infant undergoes craniotomy for an arteriovenous malformation. During the procedure, severe hemorrhaging occurs and packed red blood cells 3 units are transfused rapidly. During infusion of the third unit, hypotension, nodal bigeminy, and prolongation of the QT interval are noted. The most appropriate management includes administration of
Postoperatively a 70-kg patient has a serum sodium value of 130 mEq/L. To increase this value to 140 mEq/L would require the administration of how much sodium in mEq?
A 68-year-old woman who is receiving urokinase for deep venous thrombosis and pulmonary emboli requires emergency laparotomy for a bleeding gastric ulcer. Which of the following agents is most appropriate to reverse the effects of urokinase?
A patient receives an emergency transfusion of three units of O, Rh-negative blood for profuse hemorrhaging. If his blood type is AB, Rh-negative, which of the following is most appropriate for continuing transfusion?
After receiving excessive intraoperative blood replacement, a patient anesthetized with fentanyl, diazepam, and nitrous oxide develops acute pulmonary edema. The drug most likely to help him acutely is
Which of the following abnormalities in serum is most likely to result from intraoperative discontinuation of parenteral hyperalimentation?
Which of the following is the most common initial sign of hemolytic transfusion reaction during general anesthesia?
A patient with uremia is scheduled for emergency surgery. Bleeding time is 18 minutes. The most appropriate initial treatment is
A 48-year-old woman with von Willebrand's disease is scheduled for a hysterectomy. The most appropriate initial preoperative therapy to decrease bleeding is administration of
Which of the following is the most frequent cause of hemorrhagic diathesis after administration of 20 units of CPD-stored blood over six hours?
A 65-kg, 57-year-old man has an initial activated clotting time (ACT) of 122 seconds prior to elective cardiopulmonary bypass. Five minutes after administration of heparin 200 mg, ACT increases to 154 seconds. After two additional doses of 200 mg each from different lots, ACT increases to 240 seconds. The most appropriate next step is to
Which of the following factors is LEAST likely to affect serum ionized calcium concentration following blood transfusion?
Which of the following statements concerning banked blood is true?
Compared with blood anticoagulated with CPD, blood stored in CPDA-1 has