3. It is the injection of a volume of blood , or
parts of blood,obtained from a healthy
person (the donor) into the circulation of the
patient(the recipient) whose blood is either
deficient in quantity or quality.
It can be
1.Allogenic transfusion
2.Autologous transfusion
7. Hemorrhage(sudden blood loss greater than
20% of blood volume)
Hemoglobin level less than 8g/dl
Hemoglobin level less than 10g/dl with major
disease (e.g.emphysema, ischemic heart
disease)
Hemoglobin less than 10g/dl with autologous
blood
Hemoglobin level less than 12g/dl and
ventilator dependent
9. Example:
An 85 kg women has preoperative hematocrit of
35%.How much blood loss will decrease her
hematocrit to 30%
Est. blood volume 65ml/kg x 85 =5525ml
RBCV 35% , 5525X 35% = 1934ML
RBCV 30% , 5525X 30 % = 1658 ML
RED CELL LOSS at 30% , 1934-1658ml=276 ml
Allowable blood loss , 3x276=828 ml
So blood transfusion is done if she has lost more
than 800 ml of blood
10.
11. Indications for whole blood transfusion
1. Hemorrhage
2. Exchange transfusion
3. Pts who continue to bleed after receiving 4
units PRBC’S
Indications for packed cell transfusion
1 unit packed cell rises the level of hb by 1g/dl
and hematocrit by 3%, used when whole
blood may overload the circulation
12. 1. Chronic anemia with hge
2. Acute sickle cell crisis
3. Cardiac failure
4. Acute blood loss
5. Perioperative anemia
Indication for platelet transfusion
1. Pts with thrombocytopenia/ platelet
function defect
2. Correction of coagulopathy, prophylactic
transfusion before major surgery
13. Indications for FFP
1. deficiency of coagulation factors
2. Emergency tratment of warfarin overdosage
3. Vit k deficiency
4. Treatment ofTTP
5. Treatmnet of DIC
Indications for cryoprecipitate(factor 8,13.
fibrinogen)
1. Hemophilia
2. Hypofibrinogenimia
3. Von willebrands disease
4. DIC
5. Hepatic failure
6. Surgical bleeding
14. Indications for protein solution
Human plasma protien- hypoalbunemia,
nephrotic syndrome, liver failure
Indications for granulocyte concentrate
Severe myeloid leukemia
Indications for factor concentrate
FactorVIII, facctor IX, protein c
1. Hemophilia factorVIII
2. Christmas disease factor IX
3. Severe sepsis with DIC
15. DONOR SELECTION
Age between 18-65yrs
Hb 12g/dl
weight over 51kg
No major surgery in last 6 months
No blood transfusion In last 12 months
No clinical malaria in past 1 month
no pregnancy within last 12 months
No HIV/ HEPATITIS/SYPHILIS/ BRUCELLOSIS
Unvaccinated in last 3 weeks
16. Blood is collected in a sterile plastic bag
contatining CPD ( citrate phosphate dextrose
CPD keeps red cell viable for 21 days
CPDA extends shelf life to 35 days
Administration and rate of BT
After checking the ABO grouping of the patient
and RH typing cross matching of blood is
done
17. Blood to be transfused should be identified against
recipients name, group , hosp ID
The blood is warmed
Iv line is secured with 17 gauge needle
Initially 20-30 drops/min then 60-80 drops/min
The patients vitals gen condition is monitored
throughout
20. Febrile non hemolytic reaction
Incompatibility betweenAg onWBCs and Ab in
the recipient plasma
Presents as rigors, fever, nausea , vomiting
Mgmt
Temporary stopage of BT
If severe exclude hemolytic reaction
Paracetamol
Leucocyte depleted blood products in future
transfusions
21. Allergy to the plasma proteins in the donor
plasma
Symptoms
Utricaria, myalgia, arthralgia, bronchospasm,
oedema of face, chestpain, hypotension,
diarrhoea, shock,pyrexia
Mgmt
Stop transfusion
Antihistamine and corticosteroid given IV,
adrenaline
22. Hemolysis of donor cells, by antibodies in recipient
plasma
Symptoms
Fever, rigors, dysnoea, shock, hemoglobinuria,
jaundice, hypotension, oligo/anuria
Mgmt
Stop BT, again grouping and cross matching
done, blood culture, lab confirmation of
hemolysis, diuresis, shock correction, reverse
DIC
23. 2% of bank blood is contaminated at the time
of collection and septicaemia or endotoxic
shock may ensue
Contaminants Cryophoric bacteria,
pseudomonas, G-ve bacteria
Symtoms
Chills, fever , dry skin, hypotension, DIC
Mgmt
Stop drip, donor and recipient blood taken for
culture, IV fluids, Steroids and vasopressors
24. Leads to pulmonary oedema and CCF
Symptoms
Dyspnoea, orthopnea, cough, frothy sputum, raised
JVP, rales, rapid and weak pulse
Mgmt
Stop BT, pt propped up, iv furesemide, phlebotomy,
digitalization
25. More likely occurs in massive transfusion
Cpld blood may cool the heart and cause
arrhytmias
AIR EMBOLISM
Uncommon with collapsible plastic bags
As little as 10 ml fatal
Symptoms : gasping, respiration,cyanosis, venous
congestion, hypotension
Treatment: oxygenadministration, air aspiration
from heart
26. Thromboplebitis
Common in lower limbs
Mgmt: analgesics, culture and sensitivity
Delayed hemolytic reaction
Mild jaundice, hemolysis
Post transfusionTTP
Production of platelet alloantibody
Mgmt prednisolone iv, immunoglobulin,
plasmapheresis
Transmission of diseases: treat accordingly
27. It is defined as replacement of 50% of the patients
blood volume in 12 hrs or entire blood volume(5l) in 24
hrs or more than 4 litres blood transfused in 1 hr.
Indications
Pts undergoingExchange transfusions
Sudden loss of blood more than 25% of total BV
Trauma
Cardiovascular injury- bypass / valve replacement
Spinal/hepatic surgery
Obstetric emergencies
