PATIENT SAFETY & EARLY INTERVENTION AND MANAGEMENT

1. TOPIC NAME: ANTICOAGULANT AND ITS APPLICATION IN BLOOD BANK

2. INTRODUCTION
Before jumping to the main topic I would like to give a short introduction
about the anticoagulant and the blood bank.
ANTICOAGULANT: The drug that help to prevent the clotting of blood.
BLOOD BANK: The place where blood is collected from donors, typed,
separated into components, stored, and prepared for transfusion to
recipients.
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3. HISTORY OF BLOOD BANKING
▸ 1628: William Harvey- circulation of blood.
▸ 1665: First recorded successful blood transfusion by Richard Lower.
▸ 1818: James Blundell- first successful transfusion of human blood to
a patient.
▸ 1900: Karl Landsteiner- discover the first three human blood
groups.
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4. HISTORY OF BLOOD PRESERVATION
▸ 1914: Albert Hustin and Luis Agote kept blood in the liquid state for
48 hours using citrate.
▸ 1916: First anticoagulant preservative - Rous and Turner.
▸ It consisted of a citrate-glucose solution.
▸ Rous Turner′s solution was used for storage of human blood during
the first World War.
▸ 1943: During the second World War, Acidified Citrate Dextrose (ACD)
solution was introduced- Loutit and Mollison.
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5. HISTORY OF BLOOD PRESERVATION
▸ 1957: Glibson developed citrate-phosphate-dextrose (CPD).
▸ CPD eventually replaced ACD and became commonly used
preservative for storage of blood cells in liquid form.
▸ Shelf-life of blood stored in CPD at 2-4 degree celsius was 21 day.
▸ 1978: citrate-phosphate-dextrose with adenine (CPDA-1)
▸ The addition of adenine improved the synthesis of ATP in the
stored blood, which prolonged the stored of blood cells at 2-4
degree celsius to 35 days. 5

6. CLASSIFICATION OF ANTICOAGULANT
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7. ANTICOAGULANT PRESERVATIVE SOLUTION
▸ Acid Citrate Dextrose (ACD)
▸ Citrate Phosphate Dextrose (CPD)
▸ Citrate Phosphate Dextrose Adenine(CPDA-1) 15ml of ACD, 14ml
of CPD or CPDA is used for preserving 100ml of blood.
PURPOSE:
▸ To prevent coagulation.
▸ To preserve the life end survival of RBCs so as to have the
maximum post transfusion survival. 7

8. COMPOSITIONS OF ANTICOAGULANTS
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9. ACTION OF INGREDIENTS OF ANTICOAGULANT SOLUTION
▸ CITRATE: Acts by chelating calcium.
▸ DEXTROSE: Necessary for the metabolism of stored RBCs.
It passes from plasma into the red cells and is utilised for energy production.
The principle pathway being anaerobic glycolysis.
▸ CITRIC ACID: Presents carmalization of glucose in citrate dextrose solution
during autoclaving.
▸ ADENINE: Improves the viability of red cells.
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10. THE USES OF COAGULANTS IN BLOOD BANK
▸ EDTA (Ethylenediaminetetraacetic acid): EDTA is the
anticoagulant used for most hematology procedures. Its
primary use is for the CBC and individual components of the
CBC. The larger tube is used for blood bank procedures.
▸ SODIUM CITRATE: Sodium citrate is used for coagulation
testing and for the erythrocyte sedimentation rate in blood
bank. 10

11. ▸ DOUBLE OXALATE: It is used in concentration of 2mg for the
1ml of blood. Oxalates acts by removing calcium ions from the
plasma as in the insoluble oxalate. It is used for determination of
haemoglobin %. ESR estimation, RBCs count and leukocytes
count.
▸ HEPARIN: It works by binding to antithrombin and blocking
the clotting cascade, but it comes with its drawbacks. Heparin
can begin breaking down within 12 hours and start to lose its
anticoagulant properties, and as it is an animal product, it may
be contaminated with bacteria and viruses.
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12. ▸ SODIUM FLUORIDE: Fluoride inhibits glycolysis, and oxalate
prevents clotting by precipitating calcium.
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