Blood transfusion in newborn babies may be necessary in certain situations to address medical conditions such as anemia, jaundice, or other blood disorders.
1. Guidelines,criteria and process of
transfusion for the newborn and
blood transfusion reaction
(immediate and delayed)
Name:Pooja patel
Roll no 16
Course 410
Class BMTC semII
3. Introductio
n
IN 1923, DR JAMES SIDBERY
ADMINISTRATED BLOOD THROUGH
THE UMBILICAL VEIN TO TREAT
HDN
FIRST ET (AKA EXANGUINATION
VENESECTION SUBSTITUTIONAL
TRANSFUSION WAS REPORTED BY
DR.AP HART IN 1925
4. Definitation
• Repetitive withdrawal of small
amounts of blood and replacement
with donor blood, untill a large
portion of the original volume has
been replaced.
• Blood volume in neonates 75 to 105
ml/kg
• Withdrawing a baby’s blood which
has high bilirubin content and
replacing it with fresh food through
umbilical vein.
5. Aim:
• 1.to correct anemia by replacing
the Rh positive sensitized red cells
• 2. To remove the circulatory
antibiodies
• 3. To eliminate circulatory bilirubin
• 4. Hemoglobin disease of newborn
(HDN)
• √ABO incompability
• √Rh incompability
6. Hemolytic
disease of
the
newborn
∆cord Hb 10% or
less.
∆cord bilirubin 5
mg/dl or more
∆rise seum
bilirubin of more
than 1 mg/dl hr
∆materal antibody
titer of 1.64 or
more,positive
direct coomb’s
start and previous
history of severeslt
affected baby.
7.
8. Choice for
donor
blood
The donor blood
should be fresh
(less than 3 days
old)
The amount
needed for an
adequate
exchange is about
160ml/kg (double
the volume of the
baby)
The blood should
be cross matched
against mother
blood.
It should be made
sure that blood is
slowly warmed to
infant’s
temperature.
9. CONT
• Required for whole blood from
blood bank which is irradiated.
• Irradiated blood must be used
within 24 hours
10. Equipment
• Radiant warmer
• Respiratory support:ventilators, ET tube,AMBU bad etc
• Suction equipment
• Multi-channel monitor:heart rate, RR and So2
• Umbilical catheterization set
• NG tube and umbilical catheter
• Disposable syringes:20CV,10CV,5CV,2cc
• Three way stopcock connector x2 nos
• Sterile gloves
• I/V tubings
• Waste recipticle
• Injection tray with antiseptic
• Small dressing pack
• Sterile scalpel blade 3/11
• Injection normal saline 500ml
• Injection heparin
• Suction apparatus with mucus sucket
• Umbilical vein catheter
• Sterile linen bundle with 2 sheets and 1 biopsy towel
11.
12. Steps of
procedure
Procedure should be
carried out in an
incubator maintain the
temperature at 27-30°
centigrade
Expose and immobilize
the baby on cross spliny
Open dressing pack and
assist in cleaning of
umbilical stump
Assist in cleaning the
umbilical cord and
crapping the sterile linen
Pour 500ml of I.V. normal
saline into a sterile bowl
and add 1 ml injection
heparin into it
13. • Umbilical cord cut less than 2.5 cm from the skin surface
• Attach ligature loosely round the base of the cord. Insert umbilical catheter into the
vein
• The catheter should be filled with a flushing solution, or donor blood before
insertion
• When free flow of blood is obtained, ligature is lightened and catheter should be
deep enough to reach inferior vena cava.
• Make sure that heat source is available throughout the procedure
• Measure CVP after insertion of catheter into umbilical vein
• Take sample of Pre- exchange for investigation
• Mointor hear rate, respiratory rate and condition of the baby hourly during the
procedure
• The physician removes 10 ml of the umbilical blood replaces with 10 ml of fresh
blood immediately, until calculated volume is exchanged
• Appy cord tie at umbilicus, seal umbilicus with tincture benzoin, apply small guaze
and secure with adhesive
•
14.
15. Replace equipment and
start photo therapy
Document time of starting,
duration, complication time
,amount and type of during
and after procedure,drugs
given during procedure and
samples sent to the lab
16. Post transfusion care
• Place the baby in gradient
warmer
• Inspect umbilicus for evidence of
bleeding
• Repeat serum bilirubin as
requried
• Cbeck infant’s blood glucose
regularly
