this powerpoint presentation is made in easy to understand language for undergraduates as well as post graduate students

1. PRESENTED BY:
Dr. Ritu Gupta
PG 1ST YEAR
Dept of Conservative Dentistry and Endodontics
People’s Dental Academy , Bhopal, MP

2.  Blood
 Def
 Properties
 Functions
 Composition
 Serum
 Plasma
 Composition
 Plasma proteins
 Properties
 Normal range
 functions
 RBC
• Introduction
• Shape and size
• Properties
• Fate of RBC
• Functions
• Variations in number,
shape, size
• Hemolysis
• Erythropoiesis
 Hemoglobin
• Introduction
• Functions
• Structure
• Abnormal derivatives
 ESR & Variations
 Anemia
• Pernicious anemia
• Aplastic anemia
• Sickle cell anemia
• Iron deficiency
anemia
• Plummer Vinson
syndrome
 Thalassemia

3.  WBC
• Introduction
• Classification
• Variations
• Lifespan
• Properties
 Agranulocytosis
 Leukemia
 Platelets
• Introduction
• Properties
• Functions
• Disorders
 Hemostasis
 Blood coagulation
• Clotting factors
• Enzyme-cascade
theory
 Blood clot
 Anticoagulants
 Hemophilia
 Blood groups
• History
• Landsteiner’s law
• ABO system
• Determination of
blood groups
• Significance
• Transfusion
reactions
• Rh factor
• Incompatibilty of Rh
factor
 Erythroblastosis
fetalis
 Blood transfusion
 References

4.  It is basically connective tissue in fluid form.
It is called as fluid of life, as it carries oxygen
from lungs to all parts of the body and
carbon dioxide from all parts of the body to
lungs.
[Guyton A., Hall J. Textbook of Medical Physiology ,10/e. Singapore :
Harcourt publishers; 2001]

5.  COLOR : Scarlet red (arterial)
purple red (venous)
 Volume : 450ml (in new born)
5 litre (normal healthy male)
4.5 litre (normal healthy female)
 pH : Slightly alkaline 7.4
 Sp gravity :Total blood : 1.052-1.061
Blood cells : 1.092-1.101
Plasma : 1.022-1.026
 Viscosity : 5 times more than water

6.  Nutrient supply
 Respiratory function
 Excretory function
 Transport of hormones and enzymes
 Regulation of water balance
 Regulation of acid base balance
 Regulation of body temperature
 Storage function
 Defensive function

7. BLOOD
Blood cells
(formed
elements)
RBC
(Erythrocytes)
WBC
(Leukocytes)
Platelets
(Thrombocytes)
Liquid portion
(plasma)

8.  Serum is the clear straw colored fluid that
oozes out of the clot
 When the blood is shed , or collected in a
container, it clots because of conversion of
fibrinogen into fibrin
 After about 45 min, serum oozes out of the
clot
 For clinical investigations, serum is separated
from blood cells by centrifuging
 Volume : 55% of total blood volume
SERUM = PLASMA - FIBRINOGEN

9. COMPOSITION OF PLASMA

10.  Also called as Reserve Proteins
 Sp gravity : 1.026
 Buffer action : plasma proteins have 1/6 of
total buffering action of blood
hyperproteinemia
hypoproteinemia

11.  Total proteins: 7.3 g/dL (6.4-8.3 g/ dL)
 Serum albumin: 4.7g/ dL
 Serum globulin : 2.3 g/ dL
 Fibrinogen : 0.3 g/ dL
ALBUMIN/GLOBULIN RATIO
It is an important indicator of some liver
and kidney diseases.
Normal A/G ratio = 2.1

12.  Role in blood coagulation (fibrinogen)
 Role in defense mechanism: γ globulins act
as antibodies (immunoglobulins)
 Role in transport mechanism: albumin, α &
β globulins are responsible for the transport
of hormones and enzymes
 Role in maintenance of osmotic pressure in
blood : plasma proteins exert about 25 mm
Hg . Albumin exerts maximum pressure as
it’s conc is more than others

13.  Role in viscosity of blood : essential for
maintaining BP. Albumin provides maximum
viscosity
 Role in ESR : globulin and fibrinogen
accelerate rouleaux formation, which is
responsible for ESR
 Role as reserve proteins: act as last source of
energy in case of fasting or inadequate food
intake
 Role in suspension stability of RBC’s :
globulin and fibrinogen help in this
 Role in acid-base balance: albumin due to it’s
buffering action helps in maintaining balance

14.  RBC’s aka erythrocytes are non nucleated
formed elements in the blood
 Red color is due to hemoglobin
males : 5million /cu m
adult males : 5 million / cu mm
adult females: 4.5 million /cu mm
NORMAL VALUES

15.  Normally disc shaped &
biconcave
 Central portion thinner &
periphery thicker
 Size: diameter= 6.9-7.5μ
thickness= 2.5μ (at
periphery)
1μ (at center)
 Surface area: 120 sq μ
 Volume : 85-90 cu μ

16. Properties
Of
RBC’s
Rouleaux
formation
Suspensio
n stability
PCV /
Hematocri
t value
=45%
Sp
gravity
1.092-
1.101

17.  When blood is
taken out, RBC
pile up one
above another
like pile of coin.
This property of
RBC’s is called
rouleaux
formation

18. FATE OF RBC

19.  Transport of O₂ from lungs to tissues :
Hemoglobin + oxygen= oxyhemoglobin
 Transport of CO₂ from tissues to lungs :
Hemoglobin + CO₂ = carbhemoglobin
 Buffering action in blood
 In determination of blood groups:
Carries blood group antigens like antigen A, B
etc. that help in determination of blood groups
& enables to prevent reactions due to
incompatible blood transfusion

20. VARIATIONS IN RBC’s
NUMBER
physiological
pathological
SIZE SHAPE

21. INCREASE IN RBC COUNT
(POLYCYTHEMIA)
DECREASE IN RBC COUNT
(ERYTHROCYTOPENIA)
1. AGE
2. SEX
3. HIGH ALTITUDE
4. MUSCULAR EXERCISE
5. EMOTIONAL CONDITIONS
6. INCREASED ENV
TEMPERATURE
7. AFTER MEALS
1. HIGH BAROMETRIC PRESSURE
2. DURING SLEEP
3. PREGNANCY

22. ABNORMAL INCREASE IN
RBC COUNT (> 7
millions/cu mm)
ABNORMAL DECREASE IN
RBC COUNT
1. PRIMARY
POLYCYTHEMIA
/POLYCYTHEMIA VERA
2. SECONDARY
POLYCYTHEMIA
1. ANEMIA OF VARIOUS
TYPES

23.  Under physiological conditions, size of
RBC’s in venous blood is slightly larger than
those in arterial blood
 In pathological conditions,
1. Microcytes ( iron def anemia, prolonged
forced breathing, inc osmotic pressure in
blood)
2. Macrocytes (megaloblastic anemia,
muscular exercise, dec osmotic pressure)
3. Anisocytes (pernicious anemia)

24. The shape of RBC’s is altered in many conditions
including different types of anemia.
1. CRENATION: shrinkage in hypertonic condn
2. SPHEROCYTOSIS: globular in hypotonic condn
3. ELLIPTOCYTOSIS: elliptical in certain anemias
4. SICKLE CELL : crescentic in sickle cell anemia
5. POIKILOCYTOSIS : unusual shapes due to
deformed cell membrane. The shape will be
of flask, hammer or any other unusual shape

25.  Normally, plasma and RBC’s are in osmotic
equilibrium. When osmotic equilibrium is
disturbed, cells are affected
 It occurs during ; hemolytic jaundice, antigen
antibody reactions, poisoning by chemicals or
toxins
 Hemolysins / hemolytic agents are
substances which cause destructions of
RBC’s.
 They are of 2 types :i] chemical substances
ii] substances of bacterial
origin /found in body

26.  Erythropoiesis is the process of the
origin, development and maturation of
erythrocytes.
 Factors necessary for erythropoiesis
are classified into 3 categories:
i] general factors
ii] maturation factors
iii] factors necessary for hemoglobin
formation

28. GENERAL
FACTORS
MATURATION
FACTORS
FACTORS
NECESSARY FOR
Hb FORMATION
1. ERYTHROPOIETIN
2. THYROXINE
3. HEMOPOIETIC
GROWTH FACTORS
4.VITAMINS A,B,C,D,E
1. VITAMIN B₁₂
(extrinsic factor)
2. INTRINSIC FACTOR
OF CASTLE
3. FOLIC ACID
1. FIRST CLASS
PROTEINS & AMINO
ACIDS
2. IRON
3. COPPER
4. COBALT & NICKEL
5. VITAMIN C,
RIBOFLAVIN,
NICOTINIC ACID &
PYRIDOXINE

29.  It is the iron containing coloring pigment of
RBC.
 It forms 95% of dry weight & 30-34% of wet
weight of RBC
 Molecular weight: 68,000 mol
 Average Hb content :
in adult males : 14-15 g/ dL
in adult females : 12-14g/ dL

30.  Transports oxygen from
lungs to tissues
 Transports carbon
dioxide from tissues to
lungs
 Hb acts as a buffer and
plays an important role
in acid- base balance

31.  Hb is a conjugated protein.
 It consists of a protein called globin and an
iron containing pigment called heme
 Iron is present in an unstable ferrous (Fe⁺⁺)
form. Heme part is called porphyrin. It is
formed by 4 pyrole rings. The iron is
attached to each pyrole ring and globin
molecule.
 Globin is made up of 4 polypeptide chains :
2 α and 2β chains

33. Hb
CO
Carboxy-
hemoglobin
Hb
H₂S
Sulf-
Hemoglobin
(< 1%)
METHEMOGLOBIN is the abnormal Hb derivative formed
when iron molecule of Hb is oxidized from normal ferrous
to ferric state (Fe⁺⁺⁺) . Aka ferrihemoglobin (< 3%)

34.  ESR is the rate at which the erythrocytes settle
down
 Blood is mixed with anticoagulant and
allowed to stand undisturbed on a vertical
tube, red cells settle down due to gravity with
a supernatant layer of clear plasma
 Normal values : males 6-9 mm in one hour
females 8-15 mm in one hour
 Significance : easy and inexpensive test for
diagnosis as well as prognosis

35.  AGE : less in children and infants
 SEX : more in females than in
males
 MENSTRUATION : increases
during menstruation
 PREGNANCY : from 3rd month to
parturition increases upto 35mm
in one hour because of
hemodilution
ESR α 1/number
of RBCs

36. INCREASED ESR DECREASED ESR
1. TUBERCULOSIS
2. ALL TYPES OF ANEMIA
EXCEPT SICKLE CELL ANEMIA
3. MALIGNANT TUMORS
4. RHEUMATOID ARTHRITIS
5. RHEUMATOID FEVER
6. LIVER DISEASES
1. ALLERGIC CONDITIONS
2. SICKLE CELL ANEMIA
3. PEPTONE SHOCK
4. POLYCYTHEMIA
5. SEVERE LEUKOCYTOSIS

37.  Anemia is defined as an abnormal reduction
in the number of circulating red blood cells,
the quantity of hemoglobin and the volume of
packed red cells in a given unit of blood.
[Shafers , Textbook of Oral Pathology, 6/e. New Delhi : Elsevier
;2011]

38.  Aka Vit B₁₂ deficiency, Addisonian anemia
 Due to lack of production of intrinsic factor in
stomach
 ORAL MANIFESTATIONS
 Glossitis
 Beefy red tongue
 Hunter’s / Moeller’s glossitis
/ Bald tongue
 Loss of taste sensation
 T/t : Vit B₁₂ and folic acid administration

39.  Bone marrow failure syndrome characterized
by peripheral pancytopenia and general lack
of bone marrow activity
 1st case detected by Paul Ehrlich in 1888
 Disease was named by Chauffard in 1904
 Asso syndrome : Fanconi’s syndrome
 ORAL MANIFESTATIONS:
1. Petechiae purpuric spots on oral mucosa
2. Spontaneous gingival hemorrhage
3. Severe ulcerative lesions of OM and pharynx
may result in gangrene like condition

40.  RBC count is at a severe low of 10 lakhs/ cu
mm
 T/t :
1. Transfusion of blood
2. Bone marrow transplantation
3. Immunosuppressive therapy

41.  It is a hereditary type of chronic hemolytic
anemia transmitted as mendelian dominant
 Occurs exclusively in blacks, and in whites of
Mediterranean origin Sickle shaped RBC’s are
rapidly hemolyzed and have a lifespan of 10-
20 days
 ORAL MANIFESTATIONS:
1. Majority of patients with sickle cell anemia
exhibit significant bone changes in dental
radiographs

43. 2. Mild to severe generalized osteoporosis and
a loss of trabeculation of jaw bones with
appearance of large, irregular marrow spaces
 Radiographs of skull exhibit hair-on-end
pattern
 In lab findings, Hb level drops to 2-4 g/ dL
 T/t: management of pain, anemia, infections,
vasoocclusive crises, MODS
 Lifelong disease, not good prognosis
 Goal is to achieve normal lifespan with
minimal morbidity

44.  It is an exceedingly prevalent form of anemia,
particularly in females

45.  Occurs chiefly in women in fourth –fifth decades
of life
 Characterized by :
1. Symptoms of anemia
2. Angular cheilitis
3. Lemon tinted pallor of skin
4. Glossitis
5. Atrophy of filiform and fungiform papillae
6. Esophageal stricture or web leading to
dysphagia
7. Koilonychia (spoon shaped )
8. splenomegaly

46.  Iron therapy and a high protein diet
 Early diagnosis is crucial in order to avoid
carcinoma development
 Dysphagia caused by more advanced webs is
unlikely to respond to iron replacement alone
and thus is managed with mechanical dilation

47.  They are genetically determined disorders of
Hb synthesis with decreased production of
either α or β polypeptide chains of Hb
molecules
 Features first described by Thomas Cooley in
1925 are seen primarily in Mediterranean
populations
 therefore , also called as Cooley’s anemia,
Mediterranean anemia
 Characteristic rodent facies in children

48.  Typical safety pin cells in lab findings
 Radiographically,
1. Rib-within-a-rib appearance
2. Crew-cut/ hair-on-end appearance of
surface of skull
3. In IOPA, some cases reveal a peculiar
trabecular pattern of maxilla and mandible ,
characterized by an apparent coarsening of
some trabeculae and bluring and
disappearance of others : salt and pepper
effect
4. Thinning of lamina dura is also seen
 There is no treatment for this form of anemia

49. Rib within a rib
appearance
Salt and pepper
appearance in a
skull radiograph
Rodent Face
Appearance

50.  WBC’s or leukocytes are colorless and
nucleated formed elements of blood
 Compared to RBC’s ,these are larger in size
and lesser in number
 Functionally, play a very important role in
defense mechanism of body
 Total WBC count : 20,000/cu mm (infants)
10,000-15000 / cu mm(children)
4000- 11000/ cu mm (adults)

51.  Granulocytes
1. Neutrophils: both
acid and base stains
2. Eosinophils : acidic
stain
3. Basophils : basic
stain

52.  Agranulocytes:
they have plain
cytoplasm without
granules.
 They are of 2 types :
1. monocytes (largest
WBCs)
2. lymphocytes

53. INFECTIONS
ALLERGY
COMMON COLD
TUBERCULOSIS
GLANDULAR FEVER
ANAPHYLACTIC
SHOCK
CIRRHOSIS OF LIVER
VIRAL INFECTIONS
DISORDERS OF
SPLEEN
LEUKOCYTOSIS
LEUKOPENIA

54.  Neutrophils : 2 -15 days
 Eosinophils : 7-12 days
 Basophils : 12-15 days
 Monocytes : 2- 5 days
 Lymphocytes : ½ - 1 day

55.  Diapedesis :
the process by which the WBC’s squeeze
through the narrow blood vessels
 Ameboid movement:
neutrophils, monocytes and lymphocytes show
amebic movement characterized by protrusion
of cytoplasm and change in shape
 Chemotaxis :
attraction of WBC’s towards injured tissues by
chemical substance released at the site of
injury

56. 4. PHAGOCYTOSIS : Neutrophils and monocytes
engulf the foreign bodies by means of
phagocytosis

57.  Serious disease characterized by decreased
number of circulating granulocytes
 ORAL MANIFESTATIONS :
oral lesions constitute an imp phase of clinical
aspects of agranulocytosis
1. NUG, ulcerations of tonsils, pharynx, palate
2. Ragged necrotic ulcers covered by gray or
even black membrane
3. Hemorrhage around gingival lesions
4. Excessive salivation
5. All oral surgical procedures are
contraindicated

58. NUG
PSEUDOMEMBRANOUS
APPEARANCE

59.  It is a disease characterized by the
progressive over production of WBC’s
(>1,000,000) which usually appear in
circulation blood in an immature form
 This proliferation of WBC’s or their precursors
occurs in such an un coordinated fashion that
leukemia is generally considered a true
malignant neoplasm, particularly since the
disease is often fatal
 Acute : survival < 6 months
 Chronic : survival over 1 year

60.  Oral lesions occur in both acute and chronic
forms
 Gingivitis, gingival hyperplasia, hemorrhage,
petechiae and ulceration of mucosa
 Rapid loosening of teeth due to necrosis of
PDL
 Destruction of lamina dura, poor radiographic
definition
 It is imperative that the dentist maintain a
high index of suspicion in cases of
periodontal lesions with a somewhat unusual
appearance

62.  Platelets or thrombocytes are the formed
elements of the blood
 They are small, colorless, non nucleated and
moderately refractive bodies which are
considered to be the fragments of cytoplasm
 SIZE : diameter 2.5 μ
volume 7.5 cu μ
 NORMAL COUNT : 2- 4,00,000/cu mm

63.  ADHESIVENESS:
The property of sticking to a
rough surface
 AGGREGATION / GROUPING
OF PLATELETS :
activated platelets group
together and become sticky
 AGGLUTINATION :
clumping together of platelets

64.  Blood clotting
 Clot retraction
 Hemostasis
 Repair of ruptured blood vessel
 Role in defense mechanism
Average lifespan of platelets
is about 10 days
Older platelets are
destroyed by tissue
macrophage
System in spleen

65.  Thrombocytopenic purpura
decrease in platelet count
 Thrombocytosis
increase in platelet count
 Thrombocythemia
persistent and abnormal increase in platelet
count in carcinoma, Hodgkin’s disease, chronic
leukemia
 Glanzmann Thrombasthenia
inherited hemorrhagic disorder caused by
structural and functional abnormality of
platelets.

66.  Severe and profuse gingival hemorrhage in
majority of cases
 Petechiae on oral mucosa, appear a numerous
tiny grouped clusters of reddish spots
 Tendency for excessive bleeding
contraindicates any oral surgical procedures,
particularly tooth extraction
 TREATMENT : No specific treatment

67.  Khan F. et al, Platelets and their pathways in
dentistry : systematic review. J Int Soc Prev
Community Dent; 2017 Oct; 7(suppl 2) :S55-
S60 PMID:29184829
 Albanese A, et al. Platelet- rich plasma(PRP) in
dental and oral surgery: From wound healing
to bone regeneration. Immun Ageing. 2013;
10:1-10 [PubMed]

68.  Gunseli et al, The use of platelet rich plasma
in the treatment of immature tooth with
periapical lesion : a case report. Restore Dent
Endod.2014 Aug;39(3):230-234.
 Carlson NE, Roach RB.,Jr Platelet-rich plasma:
Clinical applications in Dentistry. J Am Dent
Assoc. 2002;133:1383-6 [PubMed]

69.  Hemostasis is defined as arrest or stoppage
of bleeding
 When a blood vessel is injured , the injury
initiates a series of reactions resulting in
hemostasis.

71.  Coagulation or clotting is the process in
which blood looses it’s fluidity and becomes
a jelly like mass few minutes after it is shed
out or collected in a container
 Coagulation of blood occurs through a series
of reactions due to activation of a group of
substances. These substances necessary for
clotting are called clotting factors

73.  This theory explains how various reactions
involved in the conversion of proenzymes to
active enzymes take place in the form of
cascade.
 3 Stages of blood clotting:
1. Formation of prothrombin activator
2. Conversion of prothrombin into thrombin
3. Conversion of fibrinogen into fibrin

75.  Defined as mesh of fibrin entangling RBCs,
WBCs and platelets
 CLOT RETRACTION : after formation, clot
starts contracting after about 30-45 min
when serum starts to ooze out . Occurs due
to contractile proteins
 FIBRINOLYSIS: lysis of blood clot inside blood
vessel is called fibrinolysis. It helps to remove
clot form lumen of blood vessel. Requires
plasmin or fibrinolysin
STREPTOKINASE (fibrinolytic enzyme ) is used
for lysis of blood clot during the treatment in
early stages of myocardial infarction

76.  These substances prevent or postpone
coagulation of blood.
 3 types:
i. Anticoagulants used to prevent clotting
inside body ; in vivo (dicoumoral, warfarin)
ii. Anticoagulants used to prevent clotting of
blood that is collected from body; in vitro
(oxalate compounds)
iii. Anticoagulants used to prevent clotting
both in vivo and in vitro (heparin, EDTA,
citrates)

77.  It is a group of sex- linked inherited blood
disorders characterized by prolonged clotting
time
 Males are affected and females are carriers
 Even mild trauma can cause bleeding to death
 Types :
HEMOPHILIA DEFICIENCY OCCURENCE
A (classic) Factor VIII 85%
B ( christmas disease) Factor IX 15%
C Factor XI Very rare

78.  Hemorrhage from many sites in oral cavity is
a common finding
 Gingival hemorrhage is massive and
prolonged
 Problem of dental extractions is difficult
 Tooth extraction by means of rubber bands
has often been used successfully, rubber
band placed around cervix of tooth and
allowed to migrate apically, causing
exfoliation through pressure necrosis of PDL

79.  Blood groups are
determined by the
presence of antigen in
RBC membrane.
 Discovered by Nobel
laureate Austrian
scientist, Karl
Landsteiner in 1901
 More than 20
genetically determined
blood groups systems
are known today

80.  Landsteiner’s law states that
1. if a particular antigen (agglutinogen) is
present in the RBCs, corresponding
antibody (agglutinin) must be absent in the
serum
2. If a particular antigen is absent in the RBCs ,
the corresponding antibody must be
present in the serum
though the second part of this law is a fact, it
is not applicable to Rh factor

81. GROUP ANTIGEN IN RBC ANTIBODY IN SERUM
A A Anti B (β)
B B Anti A(α)
AB A and B No Antibody
O No Antigen Anti A and Anti B
DETERMINATION
OF ABO GROUP IS
ALSO CALLED
BLOOD GROUPING,
BLOOD TYPING OR
BLOOD MATCHING

82. • BLOOD TYPING IS DONE
ON THE BASIS OF
AGGLUTINATION.
• Agglutination occurs if
and antigen is mixed with
it’s corresponding
antibody which is called
isoagglutinin.
• Suspension of RBC is
prepared by mixing blood
drops with isotonic saline
(0.9%)

83.  During blood transfusion, only compatible
blood must be used.
 While transfusing the blood , antigen of the
donor and antibody of the recipient are
considered
 Universal blood donor : O-ve
 Universal blood recipient : AB +ve
BLOOD MATCHING = RECIPIENT’S RBC + TEST
SERA
CROSS MATCHING = RECIPIENT’S SERUM
+DONOR’S RBC

84.  Adverse reactions in body occurring due to
mismatched blood transfusion
 Reactions may vary from fever, hives
jaundice, renal failure, shock or maybe death
 Transfusion reactions occur between donor’s
RBC and recipient’s plasma
 If recipient’s plasma contains donor’s RBCs ,
immune system launches a response against
new blood cells.
 Donor’s RBCs are agglutinated and
hemolyzed followed by release of large
amounts of Hb and complications

85.  Rh factor is an antigen present in RBC
 Antigen was discovered by Landsteiner and
Weiner
 There are many Rh antigens but only the D is
more antigenic in human
 Person having D antigen – Rh positive
 Person without D antigen – Rh negative
 Rh factor is inherited
from the father Among asian population ,
85 % of people are Rh
positive and 15% are Rh
negative

86.  Rh system is different
from ABO group system
because , the antigen D
does not have
corresponding natural
antibody (anti D)
 No risk of complications
if Rh+ve person
receives Rh–ve blood.

87.  Hemolytic disease is seen in fetus and newborn
characterized by abnormal hemolysis of RBCs
 Due to difference between Rh blood group of
mother and baby
 Erythroblasts are present in blood of fetus
 When mother is Rh –ve and fetus Rh+ve ,
usually First child escapes the complications of
Rh incompatibilty
Rh antigen cannot cross the
placental barrier whereas Rh
antibody can !!!

88.  Intrinsic staining due to red cell destruction
in jaundice, anemia leading to
hyperbilirunaemia

89.  The process of transferring blood or blood
components from donor into bloodstream
recipient.
 Essential in conditions like, anemia,
hemorrhage, trauma, burns and surgery
 BLOOD SUBSTITUTES:
substances infused in body instead of whole
blood
human plasma, 0.9% NaCl solution(saline) and
5% glucose

90.  Exchange transfusion :
removal of patient’s blood and replacement
with fresh donor blood or plasma. Also called
replacement transfusion
 Autologous blood transfusion:
collection and reinfusion of patient’s own
blood . Also called self blood donation

91.  Guyton A., Hall J. Textbook of Medical Physiology ,10/e.
Singapore : Harcourt publishers; 2001
 De Gruchy, Clinical Hematology in Medical Practice, 6/e.
UP : Blackwell Science Ltd; 2013
 Sembhulingam K., Textbook of Medical Physiology, 4/e.
New Delhi: Jaypee Brothers Medical Publishers Ltd; 2013
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