Use of Blood and Blood Components <br /> as a Medicine<br /> has come<br /> a long way!!!!<br />
AIMOF Todays Programme <br />1) To create awareness of the vital role of<br /> blood transfusion <br /> in<br />saving lives <br /> and<br /> improving the health <br /> of millions of people each year.<br />
AIMOF Todays Programme <br />2) To motivate more people to become REGULAR REPEAT VOLUNTARY DONORS <br /> so that no one suffers for the want of blood.<br />
Voluntary donation is about 27 percent as compared to 45 percent at the national level.</li></li></ul><li>How much Blood do we have?<br />On average, an adult has about <br />five to six liters<br />of blood in their circulation.<br /> The total blood volume is based on body mass.<br />Formula is <br /> 70 X Body Weight for MALES.<br /> 66 X Body Weight for FEMALES.<br />
Blood in a person<br />E .g. A male of body weight 75 Kg has 75 x 70 =<br /> 5250ml or 5.25 litres of blood.<br />
Why screen before Blood Donation????<br />For the safety of both <br /> the donor<br /> and <br /> the potential recipient .<br />
Who can Donate Blood?<br />Age :Between 18 to 60 years of Age.<br />Weight : At least 45 Kg.<br />Hemoglobin: 12.5gm%.<br />Frequency of Donations: Minimum interval between donations is 3 months.<br />Health: In good health and feeling well.<br />Screening: At the time of donation a number of questions are asked to determine donor eligibility.<br />
1.Voluntary-non remunerated. <br />2.Replacement or relative.<br />3.Professional or commercial.<br />62 countries in the world<br /> have entire collection<br /> Of blood by<br />voluntary<br /> blood<br /> donation. <br />In India approx. 50% is by Voluntary Blood Donation<br />
Screening criteria<br />Medical history<br />Preliminary health check<br />
And Takes away waste products to Kidneys.</li></li></ul><li>Components of Blood<br /> The blood circulating is referred to as ‘Whole Blood’. <br /> Whole Blood is made up of several different components each with specific applications . <br /> WHOLE BLOOD IS just a RAW MATERIAL<br />
Red cells, white cells and platelets suspended in plasma as seen under MICROSCOPE<br />
Presently only 30-35 percent blood is being used as separate components .<br />
It should increase <br /> to <br /> 70-75 percent <br /> each component is given<br /> When specifically needed <br />Rationalizing the use of blood<br />and<br /> preventing unnecessary wastage.<br />
Imagine the outcome without the availability of these drugs!!!! <br />
What are Red Cells? <br /><ul><li>Constitute the majority of cells in the blood. Approximately a quarter of the cells in the human body are red blood cells.
These cells' cytoplasm is rich in hemoglobin, an iron-containing biomolecule that can bind oxygen and is responsible for the blood's red color.</li></li></ul><li><ul><li>FUNCTION:Travel throughout the body, deliver oxygen to tissues and remove carbon dioxide to the lungs.
This role of the red cells (transporting oxygen) is essential to prevent damage to organs.</li></li></ul><li>
Where are Packed Red Cells used ?<br /><ul><li>Ask the parents of a thallesemic child.
Ask the family members of a kidney </li></ul> failure patient. <br /><ul><li> Ask the patients of severe anaemia (Whole Blood Increases Chances of Circulatory Overload).
Ask the patients of Haemolytic Anaemia.</li></li></ul><li>Packed Red Cells<br /><ul><li>Ask the patients undergoing Cancer treatment(Hypoplastic and Aplastic </li></ul> Anaemia).<br /><ul><li> Ask the patients undergoing </li></ul> Cardiac surgery .<br /><ul><li> Ask the patients undergoing Knee replacement.
Ask the patients of Road accidents . </li></li></ul><li> Packed Red Cells<br />
Packed Red Blood Cells Contraindications!!<br />LRBC should not be used:<br />1) When anemia can be corrected with specific medications, e.g., iron, B12, folic acid, erythropoietin, etc<br />2) For volume replacement.<br />
What are Platelets?<br /> Platelets are colorless,irregularly shaped bodies found in blood.<br />
Platelet Functions<br />The primary role of<br /> platelets is to prevent <br />bleeding in injured<br /> blood vessel walls by <br />forming an<br /> aggregate at<br /> the site of injury.<br />
Platelet Functions<br />Platelets can also <br /> participate in blood <br /> coagulation,<br /> inflammation <br /> and wound healing.<br />
Why platelets ? Can’t just fresh blood do the job ?<br /><ul><li>Ask a cancer Physician.
Ask a Physician treating patients with bleeding due to severely decreased production or abnormal function of platelets , as in
Drug induced or Radiation induced hypoplasia</li></li></ul><li>Platelets<br /><ul><li>Ask a Physician treating bleeding patients with platelet consumption or dilutional thrombocytopenia eg.Massive Transfusion with stored blood.</li></li></ul><li>Platelets<br /><ul><li>Can be given prophylactically to patients with rapidly falling or low platelet counts, less than 10 x 109/L (10,000/mL), secondary to cancer or chemotherapy.
Useful in selected cases of postoperative bleeding with platelet count less than 50 x 109/L (50,000/mL).
Viral disease associated with Thrombocytopenia eg.Dengue.</li></li></ul><li>Platelets<br /><ul><li>Useful in functional platelet abnormalities.</li></li></ul><li>PlateletsContraindications :<br /><ul><li>If bleeding is unrelated to decreased numbers or abnormal platelet function.
In patients with consumption of endogenous and exogenous platelets, such as in Thrombotic Thrombocytopenia Purpura (TTP) or Idiopathic Thrombocytopenia Purpura (ITP), unless the patient has a life threatening hemorrhage.</li></li></ul><li>Platelets-Preparation:<br /> Platelets are prepared from whole blood.<br /> Platelets may also be obtained by apheresis. <br /> Platelets are suspended in a small amount of the original plasma. <br />
Platelet Incubator and Agitator<br />Need to be stored with constant agitation.<br />
What are White Cells?<br /><ul><li>White blood cells travel throughout the body and protect against bacteria and viruses.
There are different types of white blood cells (granulocytes, macrophages and lymphocytes).
White blood cells can also carry some viruses and bacteria.</li></li></ul><li>Who uses White cells ?<br /><ul><li>Easily obtained by Granulocytapheresis.
Ask an intensive care physician who is struggling to save a neutropaenic patient refractory to all antibiotics.</li></li></ul><li>What is Plasma?<br /><ul><li>Plasma is a protein-salt solution that acts as a transportation medium for the other blood components.
The red cells, white cells, and platelets are suspended in the plasma.
Plasma is a straw colored clear liquid that is 90% water.</li></li></ul><li>Plasma-Functions<br /><ul><li>Plasma helps with clotting, fighting infection, maintaining blood pressure and immunity. In addition, it contains minerals (e.g., sodium and potassium).</li></li></ul><li>Plasma-Preparation<br /><ul><li>Fresh frozen plasma is separated from whole blood and frozen within 8 hours of collection (approx. 250 mL).
It can also be obtained from by apheresis (approx. 500 mL).</li></li></ul><li>Can’t one just use fresh blood?<br /><ul><li>Ask a physician involved in the care of a cirrhotic patient
Ask a Transfusion specialist wishing to do an exchange on a young TTP patient</li></li></ul><li>Fresh Frozen Plasma (FFP)Function:<br /><ul><li>Fresh frozen plasma contains the clotting factors that are necessary for hemostasis.
Plasma also has volume expansion and oncotic properties.
Fresh frozen plasma contains a normal concentration of fibrinogen and the labile coagulation factors VIII and V.</li></li></ul><li>Fresh Frozen Plasma Indications :<br />1.In bleeding patients with multiple<br />coagulation factor deficiencies <br /> secondary to liver disease,DIC and massive <br />blood transfusion.<br />2.Patients on anticogulant<br />drugs like Warfarin sodium<br />and Dicumarol are deficient in<br />
Indications<br />functional Vit.K dependent coagulation factors II,VII,IX <br />and X.If these patients are bleeding or need emergency surgery.<br />3.FFP is used in antithrombin deficiency,inherited or acquired after oral contraceptive use or in patients with liver disease.<br />
Indications<br />4.FFP is used in infants with secondary immunodeficiency associated with severe protein losing enteropathy .<br />5.FFP is used in patients who have to undergo emergency bypass surgey and are on anticoagulants. <br />6.FFP is indicated for massive transfusion (replacement of the patient’s blood volume in < 24 hours) with a demonstrated deficiency of Factor VIII and V, otherwise frozen plasma is adequate.<br />
Indications<br />7.Fresh frozen plasma is indicated in exchange transfusion in neonates.<br />
Cryoprecipitate (Cryo):<br /><ul><li>Cryo is prepared from fresh frozen plasma.