Protocols - Hemorio

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- Aplastic anemia bearers - HIV positive The blood and hemocomponents transfusion – Red blood cells concentrate or Platelets concentrate – negative for CMV, must be done before the usage of filters for the de-leukocytation. The filters must be capable to promote a de-leukocytation of at least 3 logs, on such a way that the content of residual white blood cells by bag transfused is below 10 6 . 5 - INDICATIONS FOR THE USAGE OF DE-LEUKOCYTATED COMPONENTS - Prevention of febrile transfusional reactions non-hemolytic in poly-transfused subjects - Subjects with serology known to be not reagent to CMV - Subjects candidate to bone marrow transplantation and receptors of bone marrow or peripheral progenitor cells, as a prevention of alloimmunization - Immunodepression (congenital or induced by drugs 178
TRANSFUSIONAL REACTIONS 1 – CONCEPTS TRANSFUSIONAL INCIDENTS – they are harms occurred during or after the blood transfusion, and related to it. IMMEDIATE TRANSFUSIONAL INCIDENT – those that occur during the transfusion or up to 24 h thereafter. LATE TRANSFUSIONAL INCIDENT – those that occur after 24 h of the transfusion performed. 2 – NOTIFIED TRANSFUSIONAL INCIDENT IMMEDIATE (24h) LATE (after 24 h) Acute Hemolytic Reaction Late Hemolytic Reaction Non-Hemolytic Febrile Reaction HBV / Hepatitis B Mild Allergic Reaction HCV / Hepatitis C Moderate Allergic Reaction HIV / AIDS Severe Allergic Reaction Wounds Disease Volemic Overload Syphilis Bacterial Contamination Malaria Non-Cardiogenic Pulmonary Edema / TRALI HTLV / II Non-Immune Hemolysis Antibodies appearance Hypotensive Reaction Host-versus-Graft Disease / GVHD FEBRILE REACTION: Most common reaction at the hemotherapic practice is usually associated to the presence of antibodies against the antigens HLA of white blood cells and platelets of the donor. This reaction usually occurs at the end or 1 to 2 hours after the transfusion. It presents fever and/or chills. It may be followed by mild lumbar pain, imminent death sensation. But the elevation in the temperature during a blood transfusion may be a sign of a more severe reaction such as hemolysis or bacterial contamination. HEMOLYTIC REACTION: When the transfused red blood cells are destroyed. This reaction is divided into two groups: Intravascular Hemolysis and Extravascular Hemolysis. INTRAVASCULAR HEMOLYTIC REACTION: The main cause is the ABO incompatibility, that results almost always from human mistakes, such as pre-transfusional samples barely identified, errors of blood bag identification after the cross proof or change at the time of installation. The receptor usually presents an intense lumbar pain at the first minutes after the blood transfusion is placed. He may also present: fever (with or without chills), hypotension, nauseas, dispneia and imminent death sensation. EXTRAVASCULAR HEMOLYTIC REACTION: Usually the extravascular hemolysis is manifested by fever and lumbar or abdominal pain with a mild to moderate intensity, that appear usually from 30 to 120 minutes after the transfusion is started. ALLERGIC REACTION: Divided into 3 stages according to the severity of the clinical manifestations: Mild reaction: pruritus, urticaria, erythematous plates Moderate reaction: glottis edema, Quincke edema, bronchospasm 179
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PROTOCOLS INSTITUTE OF HAEMATOLOGY
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COORDINATION AND REVISION Clarisse
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SUMMARY: PART I - CLINICAL PROTOCOL
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1.INICIAL CLINICAL EVALUATION SICKL
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TREATMENTO AND IN ADULTS AT ANY AGE
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SPLENECTOMY - INDICATIONS: (1) CHIL
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OUTPATIENT TREATMENT: It is based o
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ASPIRIN AND NSAID PARACETAMOL OPIOI
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CONDUCTION: - Hospitalization - Com
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ONE, TWO-DIMENSIONAL DOPPLER ECHOCA
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Hemianopsia Homonymous deficit of v
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TREATMENT OF CONVULSIVE EPISODES -
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INITIAL ATTENDANCE TO PREGNANT WOME
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- It may occurs acute thoracic synd
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3 Diet with potassium restriction 4
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MICROALBUMINURIA Screening Patients
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RECURRENCE OF PRIAPISM: - Pain Trea
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SPECIAL CARES DEFERASIROX - The use
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TREATAMENT: DRUG Hydroxiurea (hard
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MAJOR AND INTERMIDIATE THALASSEMIA
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HEREDIRATY SPHEROCYTOSIS CLINICAL E
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G6PD DEFICIENCY INITIAL EVALUATION
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LABS EXAMS TO DIAGNOSE APLASTIC ANE
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SELFIMMUNE HEMOLYTIC ANEMIA CONCEPT
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2. Splenectomy: Vaccinate 14 days b
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IMMUNE THROMBOCYTOPENIC PURPURA LAB
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THROMBOTIC THROMBOCYTOPENIC PURPURA
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HEMORRHAGIC SYNDROME INTRODUCTION H
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MULTIDISCIPLINARY FOLLOW-UP OF HEMO
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LYOPHILIZED CONCENTRATES: They are
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TABLE 2: REPLACEMENT THERAPY TO PER
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CONDUCTION IN CONFIRMED INTRACRANIA
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Severe CET with neurological change
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PHARMACOKINETICS OF CLOTTING FACTOR
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INHIBITORS CLASSIFICATION The inhib
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- Extended surgeries require increa
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CLINICAL DIAGNOSIS: According to In
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DDAVP TEST The “test dose” must
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TREATMENT OF BLEEDING SITUATIONS SI
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TABLE 6 - REPLACEMENT THERAPY IN LE
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• Primary prophylaxis: controvers
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CLINICAL AND LABORATORIAL FOLLOW-UP
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MYELODISPLASIC SYNDROME LABORATORIA
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If EPO < 500 mU/ml : EPO (8000U 3x/
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ACUTE MYELOID LEUKEMIA LABORATORIAL
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LMA LMA M3 - non-M3 LMA Protocol LM
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Key: Volunteer to aggressive treatm
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Acute Promyelocytic Leukemia Transf
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BMP LMA IN CHILDREN AND TEENAGERS
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Ara-c dose reduction by age: Age in
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ATRA RECOMMENDATION: ATRA is starte
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- venous hydration - leukapheresis
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POLYCYTHEMIA VERA LABORATORIAL TEST
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TREATMENT - 2nd LINE - Indicated fo
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ACUTE LYMPHOID LEUKEMIA LABORATORIA
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RE-INDUCTION Phase I (weeks 1-4) -
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Cycles 2, 4, 6, 8 - Methotrexate 20
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PHASE 2 Infusion CPM in 1 hour 1000
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CURATIVE RADIOTHERAPY of CNS < 1 ye
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CHRONIC LYMPHOCYTIC LEUKEMIA LABORA
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fludarabine 25 mg/m VENOUS 2 D1-D3
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TRICHOLEUKEMIA LABORATORIAL TESTS -
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- age >45 years old - leukocytosis
Page 128 and 129: - Leukemia / T-Cell Lymphoma in Adu
Page 130 and 131: INDICATIONS FOR THE TREATMENT: Symp
Page 132 and 133: 1 st line Chemotherapy R- CHOP (21
Page 134 and 135: CODOX- M/IVAC Cycles 1 and 3 Cyclop
Page 136 and 137: BLOCK A DEXA VO/IV 10 mg /m2 in 3 d
Page 138 and 139: - Surgical treatment is only indica
Page 140 and 141: LEUKEMIA / T-CELLS LYMPHOMA OF THE
Page 142 and 143: HN2 or PUVA (similar to the located
Page 144 and 145: MULTIPLE MYELOMA LABORATORIAL TESTS
Page 146 and 147: RESPONSE CRITERIA Full Response Abs
Page 148 and 149: WALDENSTRON MACROGLOBULINEMIA LABOR
Page 150 and 151: − If HLA-identical related donor
Page 152 and 153: TREATMENT PROTOCOL - ACUTE MYELOID
Page 154 and 155: TREATMENT PROTOCOL - MULTIPLE MYELO
Page 156 and 157: Post-autologous transplantation pro
Page 158 and 159: PART II - TRANSFUSIONAL PROTOCOLS A
Page 160 and 161: PRESERVATION AND CONSERVATION: The
Page 162 and 163: TRANSFUSION OF RED BLOOD CELLS, PLA
Page 164 and 165: FORMAL CONTRAINDICATIONS TO THE PLA
Page 166 and 167: 1 - TRANSFUSION OF FROZEN FRESH PLA
Page 168 and 169: COMMUNICATION FORM OF CRYOPRECIPITA
Page 170 and 171: Volume to be = changed (*) VOLEMIA
Page 172 and 173: HEMOTHERAPIC PROTOCOL TO FALCIFORM
Page 174 and 175: 5 - TRANSFUSIONAL CONDUCT AT THE SE
Page 176 and 177: CML - Subjects with symptoms relate
Page 180 and 181: Severe reaction: anaphylactic shock
Page 182 and 183: - Heart monitoring - Prescribe Furo
Page 184 and 185: CARES AT THE PLATELETS CONCENTRATE
Page 186 and 187: ATTACHMENT I - HEMATOLOGICAL CLINIC
Page 188 and 189: INFECTIOUS SPLENO MEGALIES IMMUNO L
Page 190 and 191: INVESTIGATION OF HEMORRHAGIC SYNDRO
Page 192 and 193: INVESTIGATION OF POLYGLOBULIAS: POL
Page 194 and 195: ATTACHMENT III - HEMATOLOGY SPECIAL
Page 196 and 197: IMMUNOPHENOTYPE PROFILE OF THE ACUT
Page 198 and 199: ATTACHMENT IV - PAIN APPROACH ROUTI
Page 200 and 201: If it is prescribed for more than 1
Page 202 and 203: HOW TO PRESCRIBE OPIOID: SPECIAL CA
Page 204 and 205: SPECIFICITIES OF EACH OPIATE (cont
Page 206 and 207: METHADONE Intravenous (*) Oral path
Page 208 and 209: Psychic Dependence or “addiction
Page 210 and 211: CROSS TOLERANCE - The subject must
Page 212 and 213: ATTACHMENT V - CHEMOTHERAPY SUBJECT
Page 214 and 215: ATTACHMENT VII - IRON CHELATION GEN
Page 216 and 217: 10. G N N - DFP DFP-100 mg/kg/day d
Page 218 and 219: ATTACHMENT VIII - SEDATION IN CHILD
Page 220 and 221: 224 NOTES _________________________
Page 222 and 223: 224 NOTES _________________________
Page 224: Expresso Gráfica e Editora Ltda-me
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Protocols - Hemorio

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