jrjatBLjgzkydodyvo7taOOD TRANSFUjzyosSION.pptx

JGZkyd

1. BLOOD TRANSFUSION

2. What makes up the blood? RED BLOOD CELLS (Erythrocytes ) – The most abundant cells in our blood; they are produced in the bone marrow and contain a protein called hemoglobin that carries oxygen to our cells. WHITE BLOOD CELLS (Leukocytes ) – They are part of the immune system and destroy infectious agents called pathogens. PLATELETS (Thrombocytes ) – The clotting factors that are carried in the plasma; they clot together in a process called coagulation to seal a wound and prevent a loss of blood. PLASMA – This is the yellowish liquid portion of blood that contains electrolytes, nutrients and vitamins, hormones, clotting factors, and proteins such as antibodies to fight infection.

3. Blood The average adult has about FIVE liters of blood inside of their body, which makes up 7-8% of their body weight. Blood is living tissue that carries oxygen and nutrients to all parts of the body, and carries carbon dioxide and other waste products back to the lungs, kidneys and liver for disposal. It also fights against infection and helps heal wounds, so we can stay healthy.

4. Cont.. Your blood type is established before you are born, by specific genes inherited from your parents. You inherit one gene from your mother and one from your father. These genes determine your blood type by causing proteins called AGGLUTINOGENS to exist on the surface of all of your red blood cells.

5. What are the blood types? There are 3 genes for blood type: A , B , & O . There are 6 possible combinations. Blood Types AA or AO = Type A BB or BO = Type B OO = Type O AB = Type AB

6. Blood typing & cross matching The differences in human blood are due to the presence or absence of certain protein molecules called antigens and antibodies . The ABO and Rhesus (Rh) systems are the most important blood group systems used for blood transfusions.

7. ABO Blood Typing According to the AB O blood typing system there are four different kinds of blood types: A , B , AB or O (null). Blood group A If you belong to the blood group A, you have A antigens on the surface of your RBCs and B antibodies in your blood plasma.

8. Cont … Blood group B If you belong to the blood group B , you have B antigens on the surface of your RBCs and A antibodies in your blood plasma. Blood group AB If you belong to the blood group AB , you have both A and B antigens on the surface of your RBCs and no A or B antibodies at all in your blood plasma. Blood group O If you belong to the blood group O (null), you have neither A or B antigens on the surface of your RBCs but you have both A and B antibodies in your blood plasma.

9. The Rh System Is based on the presence or absence of the Rh antigen . Some of us have it, some of us don't have. If it is present, then blood is RhD positive , if not it's RhD negative . So, for example, some people in group A will have it, and will therefore be classed as A+ (or A positive). While the ones that don't, are A- (or A negative). And so it goes for groups B, AB and O.

10. A person with Rh - blood can develops Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies . A person with Rh+ blood can receive blood from a person with Rh - blood without any problems.

11. Crossmatching The laboratory examination to determine a person’s blood group and Rh factor is called Blood Typing . Before any blood can be given to a patient, it must be determined that the blood of the donor is compatible with the patient . The process of determining compatibility between blood specimens is Crossmatching .

12. Blood Transfusion A blood transfusion is a procedure in which blood is given to a patient through an intravenous (IV) line in one of the blood vessels. Blood transfusions are done to replace blood lost during surgery or a serious injury. Who can give you blood? People with TYPE O blood are called Universal Donors , because they can give blood to any blood type. People with TYPE AB blood are called Universal Recipients , because they can receive any blood type. Rh +  Can receive + or - Rh -  Can only receive -

13. Indication of blood transfusion Anemia The hemodynamic status of the patient ( i.e. if the patient is in shock , having active bleeding The estimated post operative blood loss Cancer patients requiring therapy

14. Cont … The optimal hematocrit is considered to be in the range of 30% . But patients with chronic anemia (e.g. renal failure) seem to tolerate hematocrit as low as 18%-20%. Symptoms of anemia air hunger, dizziness, significant tachycardia or cardiac failure should, of course, be transfused

15. Principles of Clinical Transfusion Practices Blood Transfusion is not without hazards If possible avoid blood transfusion Transfusion is only one part of the patient’s management. Use of alternative to transfusion. eg . IV fluids Good anesthetic and surgical management to minimized blood loss. Consent form to be obtained from the patient before transfusion. The clinician should record the reason for transfusion clearly.

16. Cont … The Principle Aims of Blood Transfusion are to:- Improve oxygen carrying capacity of blood. Prevent complication Reduce hypovolemia . 1 UNIT of Blood should increase the Hgb by approx.1 g/ dL . If no improvement or reduction in Hgb – think about ongoing blood loss or destruction. You need to treat the underlying cause .

17. Component Therapy Is a new concept of giving patients specifically the component of blood that they need RBC transfusions/ packed RBC or whole blood/ Platelet transfusions Fresh frozen plasma(FFP) This allows for better use of a donated blood and avoids wastage of blood components

18. Cont … Whole blood contains 450 ml of whole blood and approximately 60ml of anticoagulant Whole blood has a shelf life of 35 days one unit of whole blood raises the recipient’s hematocrite by 3%. Packed RBC These are the remains after the plasma has been separated from whole blood. One unit raises the recipient’s hematocrite by 3%. Packed RBC may be warmed to a temperature not exceeding 37 oc before transfusion. The storage life of red blood cells is 35 days

19. Platelet concentrate Platelets are separated from one unit of blood and suspend in a small volume of the original plasma. Depending on this technique, platelets may be stored for 3-7 days One unit of platelet increases the platelet count by 5000/ml Fresh frozen plasma This is anti-coagulated plasma separated from a person’s blood and frozen within 6 hours of the time of collection. It may be stored up to 1 year. It contains all clotting factors and also provides proteins for volume expansion

20. Complication The major immunologic reactions are: Febrile non-hemolytic transfusion reactions( FNHTR) Acute hemolytic transfusion reactions Delayed hemolytic transfusion reactions Anaphylactic transfusion reactions Urticarial transfusion reactions Transmission of disease

21. Transmission of disease: With the exception of albumin , the use of all blood products carries risk of transmitting infectious diseases. These include: hepatitis Epstein- bar virus, cytomegalovirus, brucellosis, trypansomiasis and other diseases potentially transmitted by blood transfusion great concern these days is the risk of transmission of the HIV virus. It is required to screen the donated blood

22. Treatment STOP transfusion immediately Maintain the patient's airway, blood pressure, and heart rate Begin an infusion of normal saline immediately to initiate a diuresis and avoid hypotension Transfused blood with patients blood sample should be sent for analysis Steroids may decrease the immunologic consequences Diphenhydramine 25 to 50 mg of for Urticarial (allergic) rxn Administration of antipyretics