Adult Critical Care Specialty (ACCS) Practice Exam

In a patient with cardiogenic shock following a myocardial infarction, what blood product should be recommended?

1. Packed red blood cells

2. Platelet infusion

3. Fresh frozen plasma

4. Albumin solution

The correct answer is: Packed red blood cells

In the context of cardiogenic shock following a myocardial infarction, the administration of packed red blood cells is primarily indicated for improving anemia and enhancing oxygen-carrying capacity. Myocardial infarction can lead to a reduction in blood flow and oxygen delivery to tissues, exacerbating the patient’s already compromised cardiac function. In cases where the patient has low hemoglobin levels or is experiencing signs of significant blood loss, packed red blood cells serve to restore blood volume and improve overall oxygenation. While other blood products like platelets, fresh frozen plasma, and albumin solution have their roles in different clinical scenarios, they would not address the immediate need for improving oxygen transport in a patient experiencing cardiogenic shock due to myocardial infarction. Platelets are primarily used in conditions such as thrombocytopenia or when a patient is actively bleeding; fresh frozen plasma is useful for coagulopathy or to provide clotting factors; and albumin is typically used for volume expansion in specific settings but has a different mechanism of action. Thus, packed red blood cells provide a direct benefit by addressing potential anemia, which is particularly important in a patient with compromised cardiac function as a result of myocardial infarction.