This document discusses blood and blood products. It begins by introducing blood, its components and functions. It then describes various blood properties and groups. It discusses different blood products like packed red blood cells, platelets, fresh frozen plasma and their uses. The document outlines indications and contraindications for transfusions. It notes complications of transfusions and massive transfusions. Finally, it briefly introduces blood substitutes.

1. BLOOD AND BLOOD
PRODUCTS
Dr. Bijaya K. C.
Dr. Bibek Jang Thapa
Interns(NAIHS)

2. INTRODUCTION
• Blood is the connective tissue consisting of
plasma and cellular components.
• Average human has 5 litres of blood i.e., 8% of
total body weight.
• It is a transporting fluid that carries vital
substances to all parts of the body.

3. PROPERTIES OF BLOOD
• Colour:
Oxygen-rich blood : scarlet red bright crimson
Oxygen-poor blood : purple red
• pH: 7.35–7.45
• Temp: 38˚C or 100.4˚ F
• Viscosity: 5 times more viscous than water

4. 4blood and blood transfusions

5. FUNCTIONS OF BLOOD

6. BLOOD GROUPS

7. BLOOD TRANSFUSION
Indications
1. Blood loss:
– Bleeding
– Trauma
2. Inadequate production:
– Diseases such as thalassemia,
leukaemia
3. Excessive destruction of cells:
– Disease
– Mechanical

8. BLOOD TRANSFUSION contd…
• Blood for transfusion is considered safe when
it is:
– Donated by a carefully selected, healthy donor
– Free from infections that could be harmful to the
recipient
– Processed by reliable methods of testing,
component production, storage and
transportation
– Transfused only upon need and for the patient’s
health and wellbeing

9. PERI OP BLOOD TRANSFUSION

10. THINGS TO NOTE DURING TRANSFUSION
• Type and volume of each unit transfused
• Donation number
• Blood group of each unit transfused
• Time at which the transfusion of each unit
commenced
• Signature of the individual responsible for
administration of the blood
• Monitor the patient before, during and on
completion of the transfusion
• Time of completion of the transfusion
• Transfusion reaction, if any and its management

11. WHOLE BLOOD
• Whole blood = Donor blood + Anticoagulant
• 1 Unit - 450ml
• Anticoagulant (CPDA)
• Rich - coagulation factors
• Hct - 45%
• Stored at 2 - 6 ˚c
• Shelf life - 35 days

12. WHOLE BLOOD contd…
INDICATIONS CONTRAINDICATIONS
• Acute blood loss with
hypovolaemia
• Exchange transfusion
• - severe anaemia at birth
• - severe hyperbilirubinaemia
• Massive transfusion
• Cardiovascular bypass surgery
• Risk of volume overload in
patients with:
 Chronic anaemia
Incipient cardiac
failure

13. BLOOD PRODUCTS
Red Cell Concentrate
Platelet Concentrate
Granulocyte Concentrate
Fresh Frozen plasma
Cryoprecipitate
Cryo poor plasma
Stored plasma
Albumin
Immunoglobulin
Coagulation Factors
Plasma Derivatives
Plasma Components
Cellular Components
BLOOD

14. RED CELL CONCENTRATE
• Also called Packed Red Cells
• Platelets and plasma are removed
• I Unit - 330ml
• Increases Hb by 10 g/L
• Hct – 65 - 75%
• Shelf life - 35 days
• Stored at 2 - 4 ˚c in SAG-M
( saline,adenosine,glucose,mannitol )

15. INDICATIONS OF RED CELL
CONCENTRATE
• Trauma – acute blood loss > 20%
• Anaemia
• Thalassemia
• Sickle cell disease

16. PLATELETS CONCENTRATE
• Platelet rich plasma
• Stored at – 20 to 24 ˚c
• Shelf life – 5 days
• I unit = 15 - 20ml
• Increases platelet count by 5000-10,000/L

17. PLATELETS CONCENTRATE contd…
INDICATIONS CONTRAINDICATIONS
• Thrombocytopenia
• Drug induced Haemorrhage
• Prevention of spontaneous
bleeding with counts
< 20,000
•Idiopathic autoimmune
thrombocytopenic purpura
(ITP)
•Thrombotic
thrombocytopenic purpura
(TTP)
•Untreated DIC
•Thrombocytopenia
associated with septicaemia,
or in cases of hypersplenism

18. PLASMA PRODUCTS
• Fresh frozen plasma
• Cryoprecipitate
• Factor VIII concentrate
• Factor IX concentrate
• Albumin
• Prothrombin complex concentrate (PCC)
• Anti-thrombin concentrate
• Gammaglobulins

19. FRESH FROZEN PLASMA
– Plasma collected from single donor units
or by apheresis and frozen within 8 hours
of collection.
– 1 Unit – 200 - 250ml
– Increases coagulation factors by 2%
– Contains clotting factors, albumin and
immunoglobulin.
– Stored at - 40 to - 50˚c
– Shelf life – 2 years

20. INDICATIONS FRESH FROZEN PLASMA
• Single clotting factor deficiency
• Multiple clotting factors deficiencies-DIC
• Massive transfusions
• Warfarin overdose
• Haemorrhagic disease of neonates
• TTP

21. CRYOPRECIPITATE
• Supernatant precipitate of FFP
• Rich in – Factor VIII & Fibrinogen
• I unit = 15 - 20ml
• Stored at -30°C
• Shelf life – 2 years

22. INDICATIONS OF CRYOPRECIPITATE
• 1st choice for DIC
• Von Willebrand’s disease
• Fibrinogen deficiency

23. FACTOR VIII
CONCENTRATE
Indications:
– Hemophilia
Problems:
– Allergic reactions
– Hyperfibrinogenemia
after massive doses
FACTOR IX
CONCENTRATE
Indications:
– Acute bleeding and
perioperatively in
Christmas disease
Problems:
– Allergic reactions

24. 24
ALBUMIN
Indications
• Volume replacement therapy
• Plasma volume expander
• Short term management in
hypoproteinemic patients

25. PROTHROMBIN COMPLEX
CONCENTRATE (PCC)
• Derived from pooled plasma
• Contains Factor – II , IX & X
• Indication:
– Emergency reversal of warfarin therapy in
uncontrolled hemorrhage

26. ANTI-THROMBIN CONCENTRATES
– Used in anti-thrombin deficiency thrombophilia
GAMMA-GLOBULINS
- Hypogammaglobulinemia
- High doses in autoimmune diseases

27. AUTOLOGOUS BLOOD
• Collection / infusion of client’s own blood
• Can be collected weekly as long as client’s
• Upto 3 weeks before surgery
• Hct - 45%
• Stored at 2 - 6 ˚c
• Shelf life - 35 days

28. TRANSFUSION RATE
Adults Children
Whole blood 150-200 ml/hr 2-5 ml/kg/hr
PRBC 100-150 ml/hr 2-5 ml/kg/hr
Platelets/
Plasma
150-300 ml/hr 1-2 ml/min

29. DURATION FOR TRANSFUSION

30. COMPLICATIONS OF BLOOD
TRANSFUSION
ACUTE (<24 HRS) DELAYED(>24HRS)
IMMUNOLOGIC NON IMMUNOLOGIC IMMUNOLOGIC NON
IMMUNOLOGIC
•Hemolytic
reaction
•Febrile non-
hemolytic reaction
•Urticaria
•Anaphylactic
reaction
•TRALI
•Septic
•Circulatory overload
•Metabolic
•Hypocalcemia
•Hyperkalaemia
•Metabolic alkalosis
•Air embolism
•Hemoglobinaemia,
Hemoglobinuria
•Hemolytic
reaction
•Post transfusion
purpura
•Graft vs host
disease
•Infection
•Iron overload

31. MASSIVE BLOOD TRANSFUSION
• Replacement of a blood volume equivalent
within 24 hours.
– >10 units within 24 hours
– Transfusion >4 units in 1 hour
– Replacement of 50% of blood volume in 3‐4 hours
– A rate of loss >150 ml/hour

32. USES OF MASSIVE BLOOD TRANSFUSION
• Severe trauma associated with
– Liver injury
– Vessel injury
– Cardiac injury
– Pulmonary injury
– Pelvic injury

33. COMPLICATIONS OF MASSIVE
TRANSFUSION
• Coagulopathy
• Hypocalcaemia
• Hyperkalaemia
• Hypokalaemia
• Hypothermia

34. BLOOD SUBSTITUTES
• Also called artificial blood or blood surrogate
• A substance used to mimic and fulfill some
functions of biological blood
• Aims to provide an alternative to blood
transfusion
• Two types
– Biomimetic
– Abiotic

35. BLOOD SUBSTITUTES contd…
• Biomimetic substitutes mimic the standard
oxygen-carrying capacity of the blood and are
haemoglobin based.
• Abiotic substitutes are synthetic oxygen
carriers and are currently primarily
perfluorocarbon based.

36. CONCLUSION
• Blood is the essential constituent in our body.
• Blood transfusion should be done only when
necessary.
• Cross matching is essential before transfusion.
• Various blood products are used in different
conditions.
• Transfusion reactions should be identified and
treated immendately.

37. THANKYOU……