BLOOD COMPONENT PREPARATION AND THERAPY.pptx

blood bank

1. Presenter: Manish Gupta BLOOD COMPONENT PREPARATION AND THERAPY

2. Modern blood transfusion procedure practices the optimal use of every blood donation by the way of blood component therapy. The development of plastic blood collection bags with integral tubing, high speed refrigerated centrifuge, deep freezers and cell separator machines have made blood component preparation easier and practical. INTRODUCTION

3. 1. Economy of blood , as one unit of blood can be separated in to different components and used in the different patient according to their need. 2.Minimizes the hazards of whole blood trasfusion. WHY THE BLOOD COMPONENT IS PREFFERED OVER WHOLE BLOOD?

4. Is the donor blood mixed with anticoagulant and preservative solution. Whole blood has haematocrit of 35-45% and hemoglobin of approximately12 gm/dl. Now considered as raw material rather than trasfusion medium. WHOLE BLOOD

5. Massive hemorrhage. Exchange transfusion. Non availability of red cell concentrate. INDICATIONS OF WHOLE BLOOD TRANSFUSION:

6. Chronic anemia Incipient cardiac failure. CONTRAINDICATIONS :

7. Whole blood is stored at 2-6 ℃ temperature and shelf life is 42 days. Whole blood should be ABO and Rh compatible. One unit of whole blood increases the hemoglobin by 0.75 gm/dl STORAGE AND SHELF LIFE OF WHOLE BLOOD

8. Are the constituents of blood, separated from whole blood. It includes. 1.Oxygen carrying component : a. Red cell concentrate b. Leucoreduced RBC c. Frozen thawed RBC 2.Platelet Products: a. Platelet rich plasma b. Platelet concentrate BLOOD COMPONENTS:

9. 3. Plasma components: a. Fresh frozen plasma b. Cryoprecipitate c. Cryopoor plasma d. Single donor plasma 4. Granulocyte concentrate:

10. EQUIPMENTS: - Refrigerated centrifuge -Deep freezer -Refrigerator -Automated extractor -Hand sealer -Dielectric sealer -Double pan balance -Platelet incubator shaker -Thawing bath - Cryo bath -Laminar flow cabinet EQUIPMENT AND CONSUMABLES REQUIRED FOR BLOOD COMPONENT PREPARATION:

11. Consumables -Blood collection bags - Transfer bag -Bag to bag connector -Plastic cover for blood bags.

12. Various component of blood can be separated from one another because of their different specific gravities. The out come of centrifugation depend upon two main factors -Relative centrifugal force -Duration of centrifugation Preparation of blood components:

13. 1.Blood is collected in quadruple blood collection bag. 2. After blood collection, blood bag is kept at room temperature and within 6 hours it is shifted to component room for separation of different components of blood. FLOW CHART OF BLOOD COMPONENT PREPARATION:

14. 3. Then place the balanced blood bags in diagonally opposite bucket of refrigerated centrifuge. 4.Centrifuge the whole blood using a heavy spin i.e 3150 rpm with a temperature setting of 22℃ for 11 minutes. After centrifugation gently take out the bag from centrifuge.

15. 5. Then hang the primary bag in upright position on a automated extractor and put the SAGM containing and satellite bag lower side. 6. Press the button start after breaking the primary bag’s seal.

16. 7. Plasma extracts out from the top in to empty bag and labelled as fresh frozen plasma. 8. Remaining 40-70 ml of plasma and middle Buffy coat and 10-20 ml PRBC is extracted in to another empty bag.

17. 9. Then automated extractor transfers the SAGM in to primary bag containing PRBC after breaking the seal and this PRBC is labelled as Leucoreduced PRBC. 10. Hang the Buffy coat containing bag and attached empty bag at room temperature for one hour with the metal plate.

18. 11. After an hour bag is put on refrigerated centrifuge and centrifuged using a light spin i.e 890 rpm with temperature setting of 22℃ for 6 min. 12.Then Bag is keep out from centrifuge and place in upright position on automated extractor and empty satellite bag at upper side.

19. 13. Press the button start. Plasma containing the layer of platelet at the top is transferred in to the satellite bag. 14. At last Discard the bag containing leucocyte and 10-20 ml RBC.

20. Is the whole blood without plasma. Have haematocrit of 55-75% and hemoglobin approx 20gm/dl. INDICATION OF PRBC TRANSFUSION: -Severe anemia -hemolytic anemia -Various hypoplastic anemia Packed RBC:

21. PRBC have shelf life of 42 days and stored at temprature of 2-8℃. PRBC should be ABO and Rh compatible. LEUCOREDUCED PRBC: It implies the removal of at least 70% of leucocytes with loss of less than 20% RBC. Storage and shelf life of PRBC:

22. Prevents or reduces the incidence and severity of adverse trasfusion effect like- -Febrile nonhemolytic trasfusion reaction. -Sensitization to the blood product. -Transmission of certain transfusion associated disease like CMV infection. Advantage of leucoreduced PRBC:

23. Is Plasma separated from whole blood which is frozen within 6 hour of collection and stored at -20℃ temprature or below. INDICATION OF FFP TRASFUSION: -Multiple coagulation factor deficiency secondary to liver disease, DIC and dilutional coagulopathy. -Reversal of coumarin drug effect. -Antithrombin deficiency. -Immunodeficiency syndrome. -In open heart surgery. -Burn patient. FRESH FROZEN PLASMA:

24. One unit of FFP contains about 150-200 ml of plasma. Dosage is about 15 ml/kg body weight. FFP after thawing should be transfused as soon possible. No compatibility testing is required however ABO compatible FFP should be used. DOSE AND ADMINISTRATION OF FFP:

25. It is the cold insoluble portion of the plasma that precipitate when FFP is thawed between 1-6℃. It contains: -Factor VIII – 80-100 units -Fibrinogen – 150-250 mg -Von willebrand factor >cryoprecipitate is stored at -20℃ and have shelf life of one year. CRYOPRECIPITATE:

26. Hemophilia A Von willebrands disease Congenital or acquired fibrinogen deficiency. INDICATION OF CRYO TRANSFUSION:

27. INDICATIONS OF PLATELET TRANSFUSION: 1.Disseminated intravascular coagulation 2.Functional platelet abnormalities 3.Viral ds associated with thrombocytopenia e.g. DENGUE 4. Amegakaryocytic thrombocytopenia -leukemia -hypoplastic anemia 5.Dilutional thrombocytopenia PLATELET CONCENTRATE:

28. Platelet is stored at temprature of 22-30℃ in platelet incubator shaker and have shelf life of 5 days. One unit of platelet concentrate usually increases the platelet count by 5000-10000 in 70 kg weight adult. Compatibility testing is not required in platelet trasfusion. STORAGE AND SHELF LIFE OF PLATELET CONCENTRATE:

29. Usually obtained by aphaeresis. INDICATIONS: - Bone marrow showing myeloid hypoplasia. -Neutropenia<500 -Neonatal septicemia unresponsive to appropriate antibiotic therapy. GRANULOCYTE CONCENTRATE:

30. COMPONENT STORAG TEMP. SHELF LIFE .Leucoreduced 2-8℃ 42 days RBC .FFP -20℃ 1 year .Platelet 22-30℃ 5 days .cryoprecipitate -20℃ 1 year

31. Apheresis is derived from a greek word which means separation. It is the removal of whole blood from donor/patient, separation in to components ,retaining the desired/unwanted component and return of remaining constituents to the donor/patient. APHERESIS

32. 1.To collect the components for trasfusion purpose. It can be- -Plateletpheresis -Leucopheresis -Plasmapheresis 2. To remove pathological components i.e therapeutic pheresis INDICATIONS OF APHERESIS

33. Unnecessary transfusion should be avoided as it carries the risk of adverse transfusion reaction and trasfusion transmitted infection. Still the whole blood transfusion is practiced in most of the institutes which should be avoided as it overloads the patient and transfuse the component which is not required. TAKE HOME MESSAGE:

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