Blood Transfusion PDF

Blood transfusion  ILOs  Distinguish between different blood products.  Describe indications of different blood products  Classify different transfusion reactions.  Blood Products Red cell Platelet concentr Plasma concentr ate...

Blood transfusion  ILOs  Distinguish between different blood products.  Describe indications of different blood products  Classify different transfusion reactions.  Blood Products Red cell Platelet concentr Plasma concentr ate ates Plasma derivative Albumin Cryoprecipitat Coagulation factor concentrates e Immunoglobulins  Blood donation selection criteria WHO, Guidelines on Assessing Donor Suitability for Blood Donation, 2012  18-65 years Age/weight  Donors of whole blood donations should weigh at least 45 kg to donate 350 ml ± 10% and 50 kg to donate 450 ml ± 10% Female donors during menstruation can donate, defer pregnant female till 6 months after delivery and lactating female. Gender Maximizing the collection and production of plasma and platelet concentrates from male donors. Screening multiparous female donors for HLA and/or HNA antibodies. Good No malnutrition or any debilitating condition with sound mental status Look for signs of injecting drug use, tattooing , body piercing. health/Hb Haemoglobin level of not less than 12.0 g/dl for females and not less than % 13.0 g/dl for males as the threshold. Whole blood unit 450 ml whole blood donation (510 ml total volume) contains: 450 ml donor blood 63 ml anticoagulant-preservative solution Haemoglobin approximately 12 g/ml Haematocrit 35%–45% No functional platelets No labile coagulation factors (V and VIII) Infection risk Routine screening for transfusion-transmissible infections, including HIV-1 and HIV-2, hepatitis B and C, other hepatitis viruses, syphilis, malaria and Chagas disease Storage Between +2°C and +6°C in approved blood bank refrigerator, fitted with a temperature chart and alarm During storage at +2°C and +6°C, changes in composition occur resulting from red cell metabolism Transfusion should be started within 30 minutes of removal from refrigerator Indications Red cell replacement in acute blood loss with hypovolaemia Exchange transfusion Patients needing red cell transfusions where red cell concentrates, or suspensions are not available Contraindications Risk of volume overload in patients with: Chronic anaemia Incipient cardiac failure Administration Must be ABO and RhD compatible with the recipient Never add medication to a unit of blood Complete transfusion within 4 hours of commencement  RED CELL CONCENTRATE (‘Packed red cells) 150–200 ml red cells without plasma Haemoglobin approximately 20 g/100 ml Haematocrit 55%–75% Every 1 ml/kg of packed cells should increase the hematocrit by at least 1% in pediatric patients, and 1 unit will increase Hb at least 1 gm % Indications Replacement of red cells in anaemic patients thalassemia patients with a hemoglobin level less than 9.0 gm/dl Use with crystalloid replacement fluids or colloid solution in acute blood loss when the hemoglobin level is less than 13.0 gm/dl and one of the following documented conditions exist: severe pulmonary disease ,cyanotic heart disease ,heart failure to suppress endogenous hemoglobin production in patients with diagnosed sickle- cell disease when one of the following conditions exist: documented cerebrovascular accident documented acute chest syndrome documented splenic and/or hepatic sequestration documented recurrent priapism  PLATELET CONCENTRATES one unit in a volume of 50–60 ml of plasma should contain: At least 55 x 109 platelets