This document discusses red blood cell and component therapy. It covers three pillars of patient blood management: preoperative detection of anemia, intraoperative hemostasis and cell salvage, and postoperative optimization. It then describes the components that make up component therapy, including packed red blood cells (PRBC), platelets, fresh frozen plasma, cryoprecipitate, and leukoreduced and irradiated PRBCs. Indications for transfusion and potential complications are also summarized.
BLOOD & BLOOD COMPONENTS IN OBSTETRICS BY DR SHASHWAT JANIDR SHASHWAT JANI
This document provides information from Dr. Shashwat Jani regarding obstetric hemorrhage and blood transfusion. It discusses the main causes of maternal morbidity and mortality as chronic anemia and major obstetric hemorrhage. It then outlines reasons why mothers die due to hemorrhage, including inadequate resources, failure to prepare, delays in recognition and treatment, and unavailable expertise. The document also summarizes different blood products that can be used for transfusion including packed red cells, fresh frozen plasma, platelets, and cryoprecipitate. It provides indications, dosing, and guidelines for use of each component.
Blood can be separated into components like red blood cells, platelets, and plasma through centrifugation. Each component serves a distinct clinical purpose and has specifications for storage time and temperature. Red blood cells must be stored at 1-6°C for up to 35 days to maintain oxygen carrying capacity. Platelets are kept at room temperature for 5 days. Plasma and cryoprecipitate can be frozen at -18°C for up to 1 year. The appropriate blood component is transfused depending on the clinical needs of the patient.
1) Blood components like packed red cells, platelet concentrates and fresh frozen plasma can be prepared by separating whole blood into its components using centrifugation and expressors.
2) Optimal storage conditions and times allow individual components to be stored and transfused separately as needed rather than transfusing whole blood.
3) The document outlines the equipment, procedures and quality indicators for preparing the main blood components from a single donor to benefit multiple recipients.
Blood products topic is very important for Medical students as they have to know which blood product will be much beneficial to patients when they go into clinical practice. This PPT provides all of them.
This document provides information on blood component therapy. It defines terms like apheresis and plasmapheresis. It describes the two methods of obtaining platelets - platelet concentration from whole blood centrifugation and plateletpheresis. It discusses platelet concentrate quality control and storage. It also covers plasma components like fresh frozen plasma and cryoprecipitate, including their indications. The document briefly discusses other blood derivatives and recent advances in semi-automated methods and apheresis techniques using devices like Haemonetics and Gambro cell separators.
Blood can be separated into components like red blood cells, platelets, cryoprecipitate, and frozen plasma which are useful for different medical purposes. Whole blood is rarely used now due to the risk of volume overload. The Coombs test, also known as the antiglobulin test, detects the presence of antibodies and can be performed directly on a patient's red blood cells or indirectly by incubating their serum with donor red blood cells. A positive result in either test indicates the presence of antibodies.
This document summarizes different types of blood products including whole blood, red blood cell concentrates, platelet concentrates, fresh frozen plasma, and cryoprecipitate. It describes the components, storage requirements, quality control parameters, and indications/contraindications for each product. It also discusses leukodepletion of blood products and protocols to ensure the safety of blood transfusions.
This document discusses various blood products and their uses, storage, and administration. It defines whole blood, blood components, packed red blood cells, platelet transfusions, fresh frozen plasma, and cryoprecipitate. It provides indications, dosages, storage times and temperatures, and administration guidelines for each product. Potential adverse effects of transfusions like hemolytic reactions, febrile reactions, allergic reactions, and TRALI are also summarized.
BLOOD & BLOOD COMPONENTS IN OBSTETRICS BY DR SHASHWAT JANIDR SHASHWAT JANI
This document provides information from Dr. Shashwat Jani regarding obstetric hemorrhage and blood transfusion. It discusses the main causes of maternal morbidity and mortality as chronic anemia and major obstetric hemorrhage. It then outlines reasons why mothers die due to hemorrhage, including inadequate resources, failure to prepare, delays in recognition and treatment, and unavailable expertise. The document also summarizes different blood products that can be used for transfusion including packed red cells, fresh frozen plasma, platelets, and cryoprecipitate. It provides indications, dosing, and guidelines for use of each component.
Blood can be separated into components like red blood cells, platelets, and plasma through centrifugation. Each component serves a distinct clinical purpose and has specifications for storage time and temperature. Red blood cells must be stored at 1-6°C for up to 35 days to maintain oxygen carrying capacity. Platelets are kept at room temperature for 5 days. Plasma and cryoprecipitate can be frozen at -18°C for up to 1 year. The appropriate blood component is transfused depending on the clinical needs of the patient.
1) Blood components like packed red cells, platelet concentrates and fresh frozen plasma can be prepared by separating whole blood into its components using centrifugation and expressors.
2) Optimal storage conditions and times allow individual components to be stored and transfused separately as needed rather than transfusing whole blood.
3) The document outlines the equipment, procedures and quality indicators for preparing the main blood components from a single donor to benefit multiple recipients.
Blood products topic is very important for Medical students as they have to know which blood product will be much beneficial to patients when they go into clinical practice. This PPT provides all of them.
This document provides information on blood component therapy. It defines terms like apheresis and plasmapheresis. It describes the two methods of obtaining platelets - platelet concentration from whole blood centrifugation and plateletpheresis. It discusses platelet concentrate quality control and storage. It also covers plasma components like fresh frozen plasma and cryoprecipitate, including their indications. The document briefly discusses other blood derivatives and recent advances in semi-automated methods and apheresis techniques using devices like Haemonetics and Gambro cell separators.
Blood can be separated into components like red blood cells, platelets, cryoprecipitate, and frozen plasma which are useful for different medical purposes. Whole blood is rarely used now due to the risk of volume overload. The Coombs test, also known as the antiglobulin test, detects the presence of antibodies and can be performed directly on a patient's red blood cells or indirectly by incubating their serum with donor red blood cells. A positive result in either test indicates the presence of antibodies.
This document summarizes different types of blood products including whole blood, red blood cell concentrates, platelet concentrates, fresh frozen plasma, and cryoprecipitate. It describes the components, storage requirements, quality control parameters, and indications/contraindications for each product. It also discusses leukodepletion of blood products and protocols to ensure the safety of blood transfusions.
This document discusses various blood products and their uses, storage, and administration. It defines whole blood, blood components, packed red blood cells, platelet transfusions, fresh frozen plasma, and cryoprecipitate. It provides indications, dosages, storage times and temperatures, and administration guidelines for each product. Potential adverse effects of transfusions like hemolytic reactions, febrile reactions, allergic reactions, and TRALI are also summarized.
The document discusses blood and blood products. It describes how whole blood can be separated into components like packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Each component has distinct indications for transfusion based on the deficient blood fraction in patients. Proper storage and handling of components is important to maintain function. New blood substitutes are also discussed but have limitations. Overall the document provides an overview of different blood products and their clinical uses.
This document discusses blood component therapy and the advantages of separating whole blood into its components. It describes how component separation is done through centrifugation or apheresis based on the different densities of blood components. The main components that can be separated are red blood cells, platelets, plasma, and white blood cells. Separating components allows for targeted transfusion of only the needed components, improves yield from each donation, and allows multiple patients to be treated from a single donation.
This document discusses blood transfusion and component therapy. It covers the need for transfusion when there is inadequate oxygen carrying capacity or coagulation proteins. Whole blood can be separated into components like red blood cells, platelets, plasma, and cryoprecipitate to target specific needs. Proper testing and storage of components is covered. Clinical indications and transfusion triggers for different components like packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets are outlined. Blood sparing strategies like autologous donation and acute normovolaemic hemodilution are also summarized.
blood and blood component have an important role in transfusion medicine. when blood contain all its part and no separation is done thats known as whole blood but when you centrifuge and separate it that is know as component. transfusion of whole blood is now adays absolute from transfusion service and blood components are transfuses now a days which is a good practice and beneficial for the patient
Blood and blood products were presented. Key points included:
1. Blood functions to transport vital substances throughout the body.
2. Blood typing and cross-matching must be done correctly to avoid transfusion reactions.
3. Several blood products exist including packed red blood cells, platelets, and plasma derivatives that are used to treat different conditions.
4. Blood transfusions can have complications and must only be done when necessary following all safety protocols.
Packed red blood cells are prepared by centrifuging whole blood and removing the supernatant plasma, leaving red blood cells concentrated at 65-80% in a volume of 250-300mL. Platelet rich plasma is prepared by centrifuging whole blood at a lower speed to separate platelets from other components, then expressing the PRP into a satellite bag. Platelet concentrate is prepared from PRP by further centrifugation to concentrate platelets into a volume of 40-50mL. Fresh frozen plasma is prepared by centrifuging whole blood within 8 hours of collection to separate plasma, which is then frozen and can be stored for up to a year at -20°C or 7 years at -70 to -80°C.
This document discusses quality control in blood component preparation. It describes the different types of blood bags used to separate blood into components like red blood cells, plasma, and platelets. It explains the centrifugation process and parameters for various blood products. Quality assurance parameters are provided for whole blood, packed red cells, fresh frozen plasma, platelet concentrates, cryoprecipitate, and leukocyte-reduced red blood cells. The importance of component separation and uses of specific blood products are also summarized.
Platelets are non-nucleated cell fragments produced by megakaryocytes that play a key role in primary hemostasis and clot retraction. They can be collected through pooled random donor units or apheresis of a single donor. Platelets are stored at 22°C on an agitator for 3-5 days and indications for transfusion include platelet counts <10x109/L for stable patients or <50x109/L for surgical patients. Fresh frozen plasma contains all coagulation factors and is used to treat coagulopathies or reverse anticoagulation in cases of bleeding or prior to procedures.
Blood can be separated into components to meet most transfusion needs while minimizing risks. Effective separation requires centrifugation based on differences in specific gravity of components. Common components prepared include packed red blood cells, platelet concentrates, fresh frozen plasma, and granulocyte concentrates. Preparation of blood components allows for optimal use of donated blood by providing only the required constituent to the patient in need.
This document discusses the storage and uses of blood components. It defines blood products and lists the main blood components as red blood cells, platelets, granulocytes, fresh frozen plasma, and cryoprecipitate. It provides details on collection methods, separation techniques, storage conditions, and recommended uses for each component in treating conditions like blood loss, bleeding disorders, and bone marrow transplantation. The document emphasizes the importance of using only the required blood component for a condition to conserve this scarce medical resource.
Blood can be separated into components like red blood cells, platelets, fresh frozen plasma, and cryoprecipitate through centrifugation. Each component has a specific preparation method, storage requirements, and clinical indications. Red blood cells are used to treat anemia, platelets are given to prevent bleeding in thrombocytopenic patients, fresh frozen plasma can replace coagulation factors or reverse warfarin, and cryoprecipitate supplements fibrinogen levels. Proper component therapy allows multiple patients to benefit from a single blood donation by providing only the necessary components.
This document discusses blood products and plasma substitutes. It provides information on the components of blood, including plasma, red blood cells, white blood cells and platelets. It describes various blood products like whole blood, red blood cell concentrates, platelet concentrates, fresh frozen plasma and cryoprecipitate. Their preparation, storage, shelf life, indications and administration are outlined. Dried human plasma is also discussed as a plasma substitute with advantages over whole blood. Potential problems in preparation of dried plasma like transmission of viral jaundice and neutralization of plasma agglutinins are addressed.
Fresh frozen plasma (FFP) is the fluid portion of blood that has been separated, frozen, and can be stored at -18C for up to 24 months. It contains coagulation factors and proteins. FFP is administered to treat deficiencies of coagulation factors II, V, VII, IX, X, and XI when specific therapies are unavailable. It is also used to reverse the effects of warfarin anticoagulation in patients who are actively bleeding. Potential adverse effects include disease transmission, allergic reactions, alloimmunization, and transfusion-related lung injury.
A number of groups have issued clinical practice guidelines for blood component therapy in an effort to improve transfusion practices, minimize the incidence of adverse transfusion reactions, and decrease costs. This slideshow by Dr Somnath Longani, Consultant, Midland Healthcare & Research Center Lucknow explains about the Blood Component Therapy in detail.
Blood component therapy involves transfusing only the necessary components of blood needed by a patient. This reduces waste and risks compared to whole blood transfusions. The main components are red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Each component has specific functions and indications for use in treating conditions like anemia, bleeding, or coagulation disorders. Proper collection, storage, and modification of the components helps maintain their viability and functions.
This document summarizes a class seminar on dried human plasma, thrombin, and fibrinogen. It discusses how dried human plasma is obtained through blood collection and centrifugation, then processed through primary and secondary drying stages for long-term storage. Thrombin and fibrinogen are extracted from plasma and used together in a blood clotting mechanism where thrombin activates fibrinogen to form fibrin polymers for haemostasis. The seminar provided information on the preparation, uses, and mechanism of action of these substances important for blood clotting and medical emergencies.
Blood components preparation and therapeutic uses finalglobalsoin
This document discusses the preparation of blood components and their therapeutic uses. It begins by explaining how whole blood can be separated into various components to provide targeted replacement therapies. The main blood components and derivatives discussed include packed red blood cells, platelets, fresh frozen plasma, cryoprecipitate, and plasma derivatives obtained through fractionation. The document then goes into details about the history of blood transfusions and developments in blood component preparation methods, types of components, preparation processes, storage and usage guidelines. It provides information on specific blood products like platelet-rich plasma and platelet concentrates.
1) Blood is separated into components like packed red blood cells, platelets, plasma within 6 hours of collection through centrifugation.
2) Components are stored at specific temperatures and have standardized shelf lives.
3) Each component has distinct uses - packed red cells for anemia, platelets for thrombocytopenia, plasma for coagulation factor deficiencies.
The document provides an overview of blood components and their uses in clinical practice. It discusses the history of blood transfusions and the development of techniques to separate whole blood into components. The key blood components discussed are packed red blood cells (PRBC), which are used to treat symptomatic anemia. PRBC are produced by removing plasma from whole blood and allow for faster correction of hemoglobin levels compared to whole blood. The document also discusses plasma derivatives produced from large pools of donor plasma through fractionation processes. It notes the various screening tests performed on donations and techniques used to reduce risks of transfusion-transmitted infections.
This document provides information on various blood products and massive blood transfusion. It defines massive blood transfusion as replacing one entire blood volume within 24 hours or transfusing over 10 units of packed red blood cells in 24 hours. It describes components of blood like whole blood, packed red blood cells, plasma, platelets, and plasma derivatives. It discusses indications, storage, and risks of these products. It also outlines complications of massive transfusion like coagulopathy, hypothermia, acidosis, and circulatory overload and targets for resuscitation like maintaining hemoglobin, coagulation factors, platelets, pH, and temperature.
Blood transfusion involves introducing donor blood into a recipient's bloodstream. It is used to increase oxygen-carrying capacity, reverse tissue hypoxia, restore circulating volume, and provide clotting factors. Blood products include whole blood, packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Transfusions aim to treat anemia and coagulation disorders while minimizing complications like reactions, infections, or electrolyte abnormalities through careful screening, storage, and monitoring during the procedure.
The document discusses the use of blood and blood products in surgery. It covers the indications and uses of various blood products like whole blood, packed red cells, platelet concentrates, plasma derivatives, and coagulation factor concentrates. It discusses principles of blood transfusion like compatibility testing, administration procedures, and complications of transfusion. It also covers topics like massive blood transfusion protocols, autologous blood transfusion, and challenges in blood transfusion.
The document discusses blood and blood products. It describes how whole blood can be separated into components like packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Each component has distinct indications for transfusion based on the deficient blood fraction in patients. Proper storage and handling of components is important to maintain function. New blood substitutes are also discussed but have limitations. Overall the document provides an overview of different blood products and their clinical uses.
This document discusses blood component therapy and the advantages of separating whole blood into its components. It describes how component separation is done through centrifugation or apheresis based on the different densities of blood components. The main components that can be separated are red blood cells, platelets, plasma, and white blood cells. Separating components allows for targeted transfusion of only the needed components, improves yield from each donation, and allows multiple patients to be treated from a single donation.
This document discusses blood transfusion and component therapy. It covers the need for transfusion when there is inadequate oxygen carrying capacity or coagulation proteins. Whole blood can be separated into components like red blood cells, platelets, plasma, and cryoprecipitate to target specific needs. Proper testing and storage of components is covered. Clinical indications and transfusion triggers for different components like packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets are outlined. Blood sparing strategies like autologous donation and acute normovolaemic hemodilution are also summarized.
blood and blood component have an important role in transfusion medicine. when blood contain all its part and no separation is done thats known as whole blood but when you centrifuge and separate it that is know as component. transfusion of whole blood is now adays absolute from transfusion service and blood components are transfuses now a days which is a good practice and beneficial for the patient
Blood and blood products were presented. Key points included:
1. Blood functions to transport vital substances throughout the body.
2. Blood typing and cross-matching must be done correctly to avoid transfusion reactions.
3. Several blood products exist including packed red blood cells, platelets, and plasma derivatives that are used to treat different conditions.
4. Blood transfusions can have complications and must only be done when necessary following all safety protocols.
Packed red blood cells are prepared by centrifuging whole blood and removing the supernatant plasma, leaving red blood cells concentrated at 65-80% in a volume of 250-300mL. Platelet rich plasma is prepared by centrifuging whole blood at a lower speed to separate platelets from other components, then expressing the PRP into a satellite bag. Platelet concentrate is prepared from PRP by further centrifugation to concentrate platelets into a volume of 40-50mL. Fresh frozen plasma is prepared by centrifuging whole blood within 8 hours of collection to separate plasma, which is then frozen and can be stored for up to a year at -20°C or 7 years at -70 to -80°C.
This document discusses quality control in blood component preparation. It describes the different types of blood bags used to separate blood into components like red blood cells, plasma, and platelets. It explains the centrifugation process and parameters for various blood products. Quality assurance parameters are provided for whole blood, packed red cells, fresh frozen plasma, platelet concentrates, cryoprecipitate, and leukocyte-reduced red blood cells. The importance of component separation and uses of specific blood products are also summarized.
Platelets are non-nucleated cell fragments produced by megakaryocytes that play a key role in primary hemostasis and clot retraction. They can be collected through pooled random donor units or apheresis of a single donor. Platelets are stored at 22°C on an agitator for 3-5 days and indications for transfusion include platelet counts <10x109/L for stable patients or <50x109/L for surgical patients. Fresh frozen plasma contains all coagulation factors and is used to treat coagulopathies or reverse anticoagulation in cases of bleeding or prior to procedures.
Blood can be separated into components to meet most transfusion needs while minimizing risks. Effective separation requires centrifugation based on differences in specific gravity of components. Common components prepared include packed red blood cells, platelet concentrates, fresh frozen plasma, and granulocyte concentrates. Preparation of blood components allows for optimal use of donated blood by providing only the required constituent to the patient in need.
This document discusses the storage and uses of blood components. It defines blood products and lists the main blood components as red blood cells, platelets, granulocytes, fresh frozen plasma, and cryoprecipitate. It provides details on collection methods, separation techniques, storage conditions, and recommended uses for each component in treating conditions like blood loss, bleeding disorders, and bone marrow transplantation. The document emphasizes the importance of using only the required blood component for a condition to conserve this scarce medical resource.
Blood can be separated into components like red blood cells, platelets, fresh frozen plasma, and cryoprecipitate through centrifugation. Each component has a specific preparation method, storage requirements, and clinical indications. Red blood cells are used to treat anemia, platelets are given to prevent bleeding in thrombocytopenic patients, fresh frozen plasma can replace coagulation factors or reverse warfarin, and cryoprecipitate supplements fibrinogen levels. Proper component therapy allows multiple patients to benefit from a single blood donation by providing only the necessary components.
This document discusses blood products and plasma substitutes. It provides information on the components of blood, including plasma, red blood cells, white blood cells and platelets. It describes various blood products like whole blood, red blood cell concentrates, platelet concentrates, fresh frozen plasma and cryoprecipitate. Their preparation, storage, shelf life, indications and administration are outlined. Dried human plasma is also discussed as a plasma substitute with advantages over whole blood. Potential problems in preparation of dried plasma like transmission of viral jaundice and neutralization of plasma agglutinins are addressed.
Fresh frozen plasma (FFP) is the fluid portion of blood that has been separated, frozen, and can be stored at -18C for up to 24 months. It contains coagulation factors and proteins. FFP is administered to treat deficiencies of coagulation factors II, V, VII, IX, X, and XI when specific therapies are unavailable. It is also used to reverse the effects of warfarin anticoagulation in patients who are actively bleeding. Potential adverse effects include disease transmission, allergic reactions, alloimmunization, and transfusion-related lung injury.
A number of groups have issued clinical practice guidelines for blood component therapy in an effort to improve transfusion practices, minimize the incidence of adverse transfusion reactions, and decrease costs. This slideshow by Dr Somnath Longani, Consultant, Midland Healthcare & Research Center Lucknow explains about the Blood Component Therapy in detail.
Blood component therapy involves transfusing only the necessary components of blood needed by a patient. This reduces waste and risks compared to whole blood transfusions. The main components are red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Each component has specific functions and indications for use in treating conditions like anemia, bleeding, or coagulation disorders. Proper collection, storage, and modification of the components helps maintain their viability and functions.
This document summarizes a class seminar on dried human plasma, thrombin, and fibrinogen. It discusses how dried human plasma is obtained through blood collection and centrifugation, then processed through primary and secondary drying stages for long-term storage. Thrombin and fibrinogen are extracted from plasma and used together in a blood clotting mechanism where thrombin activates fibrinogen to form fibrin polymers for haemostasis. The seminar provided information on the preparation, uses, and mechanism of action of these substances important for blood clotting and medical emergencies.
Blood components preparation and therapeutic uses finalglobalsoin
This document discusses the preparation of blood components and their therapeutic uses. It begins by explaining how whole blood can be separated into various components to provide targeted replacement therapies. The main blood components and derivatives discussed include packed red blood cells, platelets, fresh frozen plasma, cryoprecipitate, and plasma derivatives obtained through fractionation. The document then goes into details about the history of blood transfusions and developments in blood component preparation methods, types of components, preparation processes, storage and usage guidelines. It provides information on specific blood products like platelet-rich plasma and platelet concentrates.
1) Blood is separated into components like packed red blood cells, platelets, plasma within 6 hours of collection through centrifugation.
2) Components are stored at specific temperatures and have standardized shelf lives.
3) Each component has distinct uses - packed red cells for anemia, platelets for thrombocytopenia, plasma for coagulation factor deficiencies.
The document provides an overview of blood components and their uses in clinical practice. It discusses the history of blood transfusions and the development of techniques to separate whole blood into components. The key blood components discussed are packed red blood cells (PRBC), which are used to treat symptomatic anemia. PRBC are produced by removing plasma from whole blood and allow for faster correction of hemoglobin levels compared to whole blood. The document also discusses plasma derivatives produced from large pools of donor plasma through fractionation processes. It notes the various screening tests performed on donations and techniques used to reduce risks of transfusion-transmitted infections.
This document provides information on various blood products and massive blood transfusion. It defines massive blood transfusion as replacing one entire blood volume within 24 hours or transfusing over 10 units of packed red blood cells in 24 hours. It describes components of blood like whole blood, packed red blood cells, plasma, platelets, and plasma derivatives. It discusses indications, storage, and risks of these products. It also outlines complications of massive transfusion like coagulopathy, hypothermia, acidosis, and circulatory overload and targets for resuscitation like maintaining hemoglobin, coagulation factors, platelets, pH, and temperature.
Blood transfusion involves introducing donor blood into a recipient's bloodstream. It is used to increase oxygen-carrying capacity, reverse tissue hypoxia, restore circulating volume, and provide clotting factors. Blood products include whole blood, packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Transfusions aim to treat anemia and coagulation disorders while minimizing complications like reactions, infections, or electrolyte abnormalities through careful screening, storage, and monitoring during the procedure.
The document discusses the use of blood and blood products in surgery. It covers the indications and uses of various blood products like whole blood, packed red cells, platelet concentrates, plasma derivatives, and coagulation factor concentrates. It discusses principles of blood transfusion like compatibility testing, administration procedures, and complications of transfusion. It also covers topics like massive blood transfusion protocols, autologous blood transfusion, and challenges in blood transfusion.
This document discusses blood products and massive transfusion protocols. It describes various blood components like packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It outlines indications for transfusing different blood products based on hemoglobin, platelet count, coagulation tests. For massive transfusion, it recommends transfusing red blood cells, plasma, and platelets in a 1:1:1 ratio to achieve therapeutic goals. It also discusses disseminated intravascular coagulation (DIC) management and complications of massive transfusion like infections, circulatory overload, and metabolic disturbances.
Whole blood can be separated into components which allows for optimal survival of each constituent and transfusion of only the specific component needed by the patient. This avoids unnecessary transfusion and allows blood from one donor to treat several patients. Components include red blood cell concentrate, platelet concentrate, leukocyte-reduced products, plasma components like fresh frozen plasma and derivatives, and cellular components like granulocytes.
This document summarizes blood transfusion, including its components, indications, storage, and complications. It discusses red blood cell concentrates, plasma, platelet concentrates, and plasma derivatives that can be transfused. The objectives, triggers, and indications for transfusion are outlined. Details are provided on blood collection, storage, and shelf life of different components. Immediate complications discussed include hemolytic and non-hemolytic reactions like allergic, febrile, and anaphylactic reactions. Delayed complications mentioned are delayed hemolytic transfusion, post-transfusion purpura, graft-versus-host disease, and transfusion-transmitted infections.
This document summarizes the components of blood and their clinical uses. It discusses whole blood as well as separated blood components including red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. For each component, it describes what it contains, how it is prepared, appropriate clinical indications and transfusions guidelines, dosing and expected results, contraindications and precautions. It also provides instructions for proper storage of blood products prior to transfusion. The overall purpose is to explain the definitions and appropriate clinical use of different blood components.
Surgery resident postgraduate presentation on the use of blood and products presented dept of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria
This document provides guidelines for blood transfusion practices. It discusses the history of blood transfusions from the early 1900s developments to modern practices. It outlines the components of blood that can be transfused including red blood cells, platelets, fresh frozen plasma, and cryoprecipitated anti-hemophilic factor. Thresholds and indications for transfusing each component are provided based on factors like hemoglobin level and platelet count. Proper procedures for blood transfusions including consent, preparation, and compatibility checking are also outlined.
Blood Component Therapy: What a clinician needs to know !Muskaan Khosla
Blood component therapy involves separating whole blood into its components through centrifugation, including red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. This allows specific components to be transfused based on patient needs, reduces waste, and enables blood from one donor to help multiple recipients. Key components are red blood cells, platelets, fresh frozen plasma, and cryoprecipitate, each with different functions, storage, and transfusion guidelines.
This document summarizes different blood products used in massive transfusion protocols including whole blood, red blood cell concentrates, fresh frozen plasma, platelet concentrates, and cryoprecipitate. It describes their components, volumes, and shelf lives. The document also defines massive transfusion and indications for different blood products. Viscoelastic assays like thromboelastography and rotational thromboelastometry are described which can detect trauma-induced coagulopathy and guide transfusion in massive bleeding situations. Scoring systems like ABC score and TASH score are also summarized which help predict patients needing massive transfusion.
This document discusses various blood components used in transfusion therapy, including their properties, collection, storage, and clinical indications. It covers red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Key points include how each component is prepared from whole blood, typical volumes and contents, storage guidelines, dosage recommendations, and common clinical scenarios where their use is appropriate or contraindicated.
The document provides an overview of blood transfusion, including donor selection, blood components and their indications, pre-transfusion handling, administration principles, massive transfusion, autologous transfusion, complications and their management, and blood substitutes. Donor selection involves medical history screening and health assessments. Key blood components discussed are packed red blood cells, platelet concentrates, fresh frozen plasma, and cryoprecipitate. Proper storage, grouping, compatibility testing and administration procedures are outlined to ensure safety. Complications can be immediate or delayed, including infections transmitted and reactions to plasma proteins. Blood substitutes under development aim to replace functions of plasma, red cells and platelets.
Blood transfusion can cause both immune-mediated and non-immune complications. Immune reactions include acute hemolytic transfusion reactions caused by ABO incompatibility, delayed hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, graft-versus-host disease, and transfusion-related acute lung injury. Non-immune risks are fluid overload, hypothermia, and electrolyte toxicity such as hyperkalemia. It is important to carefully match blood type and screen for antibodies to prevent immune complications of transfusion.
Transfusion of blood and blood products can be used to treat various conditions related to deficiencies in red blood cells, platelets, or clotting factors. There are several types of blood products including packed red blood cells, fresh whole blood, platelet concentrates, fresh frozen plasma, and cryoprecipitate. Massive transfusions involving 10 or more units of blood in 24 hours require special consideration and guidelines recommend maintaining a 1:1:1 ratio of plasma, platelets, and packed red blood cells. Acute normovolemic hemodilution involves removing blood pre-operatively and replacing volume with crystalloids or colloids to reduce transfusion needs during anticipated significant blood loss.
Blood product transfusion and massive transfusionpankaj rana
Blood transfusion
Plastic bag 0.5–0.7 liters containing packed red blood cells in citrate, phosphate, dextrose, and adenine (CPDA) solution
Plastic bag with 0.5–0.7 liters containing packed red blood cells in citrate, phosphate, dextrose, and adenine (CPDA) solution
ICD-9-CM 99.0
MeSH D001803
OPS-301 code 8-80
MedlinePlus 000431
[edit on Wikidata]
Blood transfusion is generally the process of receiving blood or blood products into one's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors, and platelets.
This document provides an overview of blood transfusion including indications, measurement of blood loss, types of blood transfusion, donation and collection, administration of blood, and complications. It discusses indications for different blood components like whole blood, packed red blood cells, platelet rich plasma, fresh frozen plasma, cryoprecipitate, and various factor concentrates. Methods of measuring blood loss and amount of transfusion are described. The process of blood donation, collection, storage and administration is outlined. Immediate complications like febrile reactions, allergic reactions, hemolytic reactions, bacterial contamination, circulatory overload, and air embolism are summarized. Delayed complications of thrombophlebitis, delayed hemolytic reactions, and post-trans
Blood groups,blood components and blood transfusion By Dr Bimalesh Kumar GuptaDrbimalesh Gupta
This document provides an overview of blood groups, blood components, and blood transfusion. It defines key terms like blood, blood products, and blood transfusion. It describes the major blood groups like ABO and Rh, and the process of cross-matching. It discusses components of blood like red cells, platelets, fresh frozen plasma, and cryoprecipitate. It covers topics like blood donation, transfusion reactions, and alternatives to transfusion. Overall, the document provides a comprehensive overview of blood and transfusion medicine.
BLOOD COMPONENTS TRANSFUSION AND ITS COMPLICATIONS.pptxKhushbooGarg61
1) Blood can be separated into components through whole blood collection or apheresis. The main components are packed red blood cells (PRBC), platelet concentrates, fresh frozen plasma (FFP), and cryoprecipitate.
2) Platelet concentrates can be prepared from single donor apheresis or from random donors. Random donor platelets contain lower platelet counts but expose recipients to fewer donors.
3) Transfusion of PRBCs is indicated when patients show signs of anemia such as low hemoglobin levels or oxygen delivery issues. The decision to transfuse depends on multiple clinical factors rather than hemoglobin level alone.
A Review On Hematology and Oncology EmergenciesChew Keng Sheng
This document provides information on blood products and their indications for transfusion, including:
- Packed red blood cells are generally indicated when hemoglobin is less than 10g/dL and almost always below 6g/dL. They increase hemoglobin by about 1g/dL per unit.
- Fresh frozen plasma contains clotting factors and is used to treat clotting factor deficiencies or massive bleeding requiring transfusion of over 5 units of packed red cells.
- Platelets are used to treat thrombocytopenia, with thresholds for transfusion depending on risk of bleeding. One unit raises platelet count by 5,000-10,000 cells/mm3.
- Complications of transfusion include allergic
This document discusses weaning from mechanical ventilation. It defines key terms like liberation, extubation, spontaneous breathing trials (SBT), and weaning success and failure. It describes the process of conducting an SBT to assess readiness for extubation. Factors that can lead to weaning failure like respiratory load, cardiac load, neuromuscular issues, and psychological factors are reviewed. Finally, it discusses using different ventilator modes like pressure support ventilation to aid in more difficult weaning cases.
Tracheostomy is an artificial opening created in the trachea in the neck to allow access to the lower airway. It has major indications for preventing laryngeal damage from prolonged intubation, managing secretions, and providing stable airway access for prolonged mechanical ventilation. The techniques include open surgical and percutaneous dilatational tracheostomy. Early tracheostomy within 7 days of cardiac surgery has been shown to improve outcomes compared to late tracheostomy by reducing atrial fibrillation, kidney dysfunction, ICU stay, and hospital stay with no increase in mortality or infections. Complications can occur during surgery or post-operatively including hemorrhage, pneumothorax, nerve injury, and infections. Care involves tube
1. This document provides protocols for ventilator settings for adults, children aged 1-10 years, and neonates/infants. It includes guidelines for initial settings, adjusting settings based on blood gas results, criteria for weaning and extubation.
2. The protocol outlines steps for changing settings from initial pressure-regulated volume control (PRVC) to synchronized intermittent mandatory ventilation (SIMV) and lists criteria for determining readiness for a spontaneous breathing trial.
3. Special considerations are provided for various clinical situations like post-cardiac surgery patients, pulmonary issues, and open sternum cases.
This document defines infective endocarditis and discusses its pathogenesis, clinical features, diagnosis, treatment and complications. Some key points:
- Infective endocarditis is defined as an infection of the endocardial surface of the heart, including heart valves. It most commonly affects the atrial side of the AV valves and ventricular side of semilunar valves.
- Staphylococcus aureus is now the most common causative organism, whereas streptococci were previously more common. Risk factors include underlying heart conditions, intravenous drug use, and invasive procedures.
- Clinical features include fever, heart murmur, embolic events, and immunological findings like Roth spots and Osler nodes
1. Congenitally corrected transposition of the great arteries (cc-TGA) involves atrioventricular and ventriculoarterial discordance.
2. Patients often present with ventricular septal defects, heart block, or ventricular dysfunction. The risk of complete heart block increases by 2% each year.
3. Surgical options include repair of associated defects while maintaining discordance, or an anatomic repair to place the morphological left ventricle as the systemic ventricle. The approach depends on the severity of lesions and individual patient factors.
This document provides an overview of intra-aortic balloon counterpulsation (IABP). It discusses the history and physiological effects of IABP, including increasing coronary perfusion and decreasing cardiac work. Indications for IABP include acute myocardial infarction and cardiogenic shock. The document reviews IABP instrumentation, monitoring, waveforms, timing, complications, weaning, and removal. IABP is a temporary circulatory support device that aims to improve heart function through counterpulsation.
This document discusses various laboratory tests used to monitor coagulation, including clotting time, prothrombin time and INR, activated partial thromboplastin time, fibrinogen level, fibrin degradation products, D-dimer, and tests for monitoring anticoagulants like heparin. It provides details on what each test measures, its normal range and clinical uses, and potential causes of abnormal results. It also discusses limitations and factors that can influence certain tests, as well as newer techniques for individualized monitoring and dosing of heparin.
This document discusses coronary artery anomalies associated with congenital heart disease. It notes that coronary anomalies can be associated with or due to congenital heart diseases like tetralogy of Fallot, transposition of the great arteries, truncus arteriosus, and pulmonary atresia with intact ventricular septum. It provides details on common coronary artery patterns and surgical management options for addressing anomalous coronary arteries during repair of various congenital heart defects.
1. The document describes a case of a 28-year-old female with cyanotic congenital heart disease who underwent an arterial switch operation with integrated ECMO support.
2. ECMO is a form of extracorporeal life support used for both cardiac and respiratory failure in adults. It involves pumping blood out of the body to an artificial lung for gas exchange before returning it to circulation.
3. The key components of an ECMO circuit include a blood pump, membrane oxygenator, tubing, heat exchanger, and monitoring equipment. Proper anticoagulation and flow rates are important for safety and effectiveness.
Evolution of management stratergy for TGAIndia CTVS
This document discusses the evolution of surgical management strategies for transposition of the great arteries (TGA). Early palliative procedures like atrial septectomy had high mortality. The atrial switch procedures (Senning and Mustard) developed in the 1950s-60s provided longer term survival but were associated with complications like arrhythmias, systemic ventricular dysfunction, and obstruction of venous pathways. The arterial switch operation developed in 1975 revolutionized treatment by anatomically correcting the defect. However, early attempts were unsuccessful due to technical challenges like coronary artery transfer. The landmark successful case by Jatene in 1975 established the arterial switch as the standard of care for TGA, though early mortality rates were still high at some centers. Long term
This document discusses heart transplantation, including indications, donor and recipient criteria. It provides a brief history of heart transplantation from early experiments to modern procedures. Key points include common indications for transplant like dilated cardiomyopathy, the importance of matching donor and recipient size and blood type, and selecting recipients without other medical issues that could impact outcomes. Contraindications and special considerations for procedures like ABO incompatible and pediatric transplants are also summarized.
Hypoplastic left heart syndrome (HLHS) is characterized by underdevelopment of the left side of the heart. It requires multi-stage surgical intervention to establish an adequate circulation. The first stage, known as the Norwood procedure, involves reconstructing the aortic arch and creating a shunt to provide pulmonary blood flow. Subsequent stages include the hemi-Fontan/Glenn procedure and final Fontan completion. Alternative treatments include heart transplantation or hybrid approaches. Long-term survival has improved but remains dependent on surgical expertise and individual patient risk factors. Ongoing management focuses on achieving balanced systemic and pulmonary circulations through each stage of treatment.
Pumps, oxygenators, and priming solutions are essential components of cardiopulmonary bypass. There are two main types of pumps - roller pumps and centrifugal pumps. Roller pumps work by rolling blood through tubing while centrifugal pumps use centrifugal force to move blood. Membrane oxygenators allow for gas exchange through a semi-permeable barrier, separating blood from gas, and eliminating the damage caused by bubble oxygenators. Proper selection of the components depends on factors such as flow needs, biocompatibility and minimizing trauma to blood during bypass.
1. The document outlines the history and evolution of surgical techniques for treating transposition of the great arteries (TGA).
2. Early techniques included atrial septal defect creation (Blalock-Hanlon) and atrial switch operations by Senning and Mustard using flaps or baffles.
3. The arterial switch operation was first successfully performed by Jatene in 1975 and modified by Lecompte, allowing coronary artery transfer.
4. Advances now allow arterial switch in neonates and extended to 6 months with support like ECMO.
This document discusses pediatric extracorporeal membrane oxygenation (ECMO) management including:
- Types of ECMO including venovenous and venoarterial
- Ventilator, coagulation, nutrition, inotrope, and sedation management of children on ECMO
- Monitoring of vital signs and investigations including echocardiograms and blood work
- Guidelines for weaning children from ECMO when stable and meeting criteria
- Potential complications of ECMO like bleeding, infection, and neurological injury and their management
- Procedures that can be done while a child is on ECMO
This document discusses the diagnosis and management of total anomalous pulmonary venous connection (TAPVC). It covers the types of TAPVC, diagnostic tools including ECG, CXR, echocardiography and catheterization, and surgical and interventional treatment options. The key points are:
1. TAPVC is diagnosed using imaging modalities like echocardiography, CT, and catheterization to identify the anomalous pulmonary vein drainage.
2. Surgical repair is the definitive treatment and involves anastomosis of the pulmonary veins to the left atrium. Factors like age, type of TAPVC, and presence of obstruction determine timing of surgery.
3. Post-operative management focuses on stabil
This document discusses the pathophysiology of constrictive pericarditis (CCP). CCP is caused by a thickened and fibrotic pericardium that restricts heart filling. This leads to 4 key hemodynamic changes: 1) impaired diastolic filling, 2) dissociation of intrathoracic and intracardiac pressures with respiration, 3) excessive ventricular coupling, and 4) heart rate dependent filling. The thick pericardium equalizes pressures in all chambers and abruptly halts early diastolic filling. Inspiration decreases left ventricular filling while increasing right ventricular filling via septal shift. Expiration causes the opposite effect.
This document discusses the history and evolution of mechanical heart valve substitutes from the 1950s to the present. It describes early ball and cage valves developed by Harken and Starr-Edwards in the 1950s-60s that helped ignite the field of prosthetic heart valves but had limitations. It then covers the development of tilting disc valves including the Bjork-Shiley valve that was later recalled due to failures, and bileaflet valves such as the St. Jude Medical valve made of durable pyrolytic carbon. The document traces the materials, designs and improvements made to mechanical heart valves over decades to increase effectiveness and safety.
This document provides a history of heart valve substitutes, beginning with the first implantation of homografts in the 1950s-1960s and moving to the development of xenograft valves fixed with glutaraldehyde in the 1960s-1970s. It discusses the work of Carpentier in developing low-pressure fixation and mechanical protection of valves. Various generations of bioprosthetic valves are summarized, including advances in fixation methods and anti-mineralization treatments. Stentless valves are introduced, providing improved hemodynamics over stented valves but requiring more complex implantation.
1. Ventricular septal defects (VSDs) are one of the most common congenital heart defects, accounting for 20-30% of cases in India.
2. The natural history and progression of a VSD depends on factors like its size, location, and the development of pulmonary hypertension.
3. Small VSDs have over a 50% chance of spontaneous closure by age 5, while larger defects often require surgical intervention. Without treatment, complications can include congestive heart failure, pulmonary vascular disease, bacterial endocarditis, and aortic regurgitation.
Selective alpha1 blockers are Prazosin, Terazosin, Doxazosin, Tamsulosin and Silodosin majorly used to treat BPH, also hypertension, PTSD, Raynaud's phenomenon, CHF
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Allopurinol, a uric acid synthesis inhibitor acts by inhibiting Xanthine oxidase competitively as well as non- competitively, Whereas Oxypurinol is a non-competitive inhibitor of xanthine oxidase.
BBB and BCF
control the entry of compounds into the brain and
regulate brain homeostasis.
restricts access to brain cells of blood–borne compounds and
facilitates nutrients essential for normal metabolism to reach brain cells
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Can Traditional Chinese Medicine Treat Blocked Fallopian Tubes.pptxFFragrant
There are many traditional Chinese medicine therapies to treat blocked fallopian tubes. And herbal medicine Fuyan Pill is one of the more effective choices.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
As the world population is aging, Health tourism has become vitally important and will be increased day by day. Because
of the availability of quality health services and more favorable prices as well as to shorten the waiting list for medical
services regionally and internationally. There are some aspects of managing and doing marketing activities in order for
medical tourism to be feasible, in a region called as clustering in a region with main stakeholders groups includes Health
providers, Tourism cluster, etc. There are some related and affecting factors to be considered for the feasibility of medical
tourism within this study such as competitiveness, clustering, Entrepreneurship, SMEs. One of the growth phenomenon
is Health tourism in the city of Izmir and Turkey. The model of five competitive forces of Porter and The Diamond model
that is an economical model that shows the four main factors that affect the competitiveness of a nation and its industries
in this study. The short literature of medical tourism and regional clustering have been mentioned.
2. PATIENT BLOOD MANAGEMENT
THREE PILLARS OF CARE
• Preoperative: detect anemia
• Intra-operative: hemostais and cell salvage
• Post operative: optimization
3. WHY ?
One donated unit can help multiple patients
• Conserves resources
• Optimal method for transfusing large
amounts of a specific component
4. COMPONENTS
A blood component is a constituent of blood,
separated from whole blood, such as:
• Red cell concentrate
Plasma
Platelet concentrate
Cryoprecipitate, prepared from fresh frozen
plasma; rich in Factor VIII and fibrinogen
5. WHOLE BLOOD
• 450 mL whole blood in 63 mL
anticoagulant‐preservative solution
CONTENT
• Hb=1.2 g/dL, haematocrit (Hct)= 35‐45%
• No functional platelets or labile coagulation
factors (V and VIII )
STORED
+2°C to +6°C
7. PRBC (PACKED RED BLOOD CELL)
• Red blood cells from which most of the
plasma has been removed
CONTENT
• Hb =20 g/100 mL (not <45 g per unit), Hct
55‐75%
STORED
• Stored at +2°C to +6°C
8. PRBC cont..
IN BAG
200ml of RBC+100ml optisol+30ml of plasma
DOSING
• Hb should be measured before and after every unit of RBCs
transfused
• Increase by 1g/dl, Hct by 3%
PAEDS
10ml/kg increase by 2g/dl
Satellite bags:50ml
5ml/kg bolus->1mg/kg furosemide->5ml/kg/hr
10. INDICATIONS
Clinical signs and biochemical markers of inadequate oxygen
delivery
CLINICAL
• Tachycardia
• Hypotension
• Tachypnea or dyspnea
LAB
• Elevated blood lactate concentration (>2mmol/lt)
• Low pH (<7.2)
• Low central or mixed venous oxygen saturation (<60/50%)
11. INDICATIONS cont..
Signs of end-organ dysfunction
• Electrocardiographic (ST changes, onset of
arrhythmias) or echocardiographic indications of
myocardial ischemia
• Electroencephalographic indications of cerebral
hypoperfusion
• New onset oliguria (less than 0.5 mL/kg/h for >6 h)
12. TRANSFUSION TRIGGERS
• Hct <26%, no indication of transfusion if Hct
>30%
• Contains no clotting factors,so if >4-5units
required give FFPs also
Perioperative transfusion
• 8g/dL for patient undergoing cardiovascular
surgery
Chronic anaemia
• 7g/dL in adults
13. Processing Residual Circuit Whole
Blood
Three re-infusion methods
– Direct Ann Thorac Surg. 1993;56(4):938-43.
– Cell-Wash JECT. 1996;28(3):134-9.
– Ultrafiltration Perfusion. 2005;20(6):343-9.
Final Infusion Volume Contents
Technique
Volume cc
%
HCT
Plt Cnt
109/L
[Fib]
mg/dL
% Clot
Factors
Direct
700-1800+
17-25 50-140 80-135 15-40
Cell-wash
225-450
40-58 5-25 10-30 2-10
Ultrafiltration
450-1000
45-55 125-325 225-385 85-259
14. Ultrafiltration Versus Cell
Washing
Residual CPB Circuit Whole Blood
Issue Ultrafiltration Cell-Washing
Clotting factor preservation Concentrates remaining factors Discards clotting factors
Protein (fibrinogen) preservation Concentrates Albumin and Fibrinogen Discard albumin and fibrinogen
Allogeneic transfusion avoidance
Helps to avoid use of PRBCs and
component therapy
Helps to avoid use of PRBCs;
May increase the use of
component therapy
Heparin / drug removal Concentrates some drugs Removes many drugs
Platelet / RBC / WBC preservation Concentrates Functional Blood Cells
May waste or activate Platelets,
WBCs and RBCs
Interleukin / complement removal Removes some ILs complements
Removes some ILs or
complements
Contamination Should not introduce bacteria CW product contains bacteria
Fat removal May remove some fat Removes some fat
Cost-savings
Cost savings with decreased
allogeneic component therapy
Some cost savings with
reduced allogeneic PRBC use
1 Roeder. J Extra Corpor Technol. 2004;36(2):162-5.
2 Samolyk. Perfusion. 2005;20(6):343-9.
3 Jackson. J Extra Corpor Technol. 2006;38(1);A86.
4 Beckmann. J Extra Corpor Technol. 2007;39(2):103-8.
5 Riley. J Extra Corpor Technol. 2007;39(1)A3.
15. Platelet concentrates (PC)
• From pooled buffy coat-derived platelets from four whole blood
donations, suspended in platelet additive solution and the plasma
of one of the four donors
• As an adult therapeutic dose obtained from a single donor by
apheresis donation
CONTENT
• 50‐60 mL plasma that should contain ≥55 x 109 platelets
• Pooled unit, i.e. platelets prepared from 4‐6 donor units containing
at least 240 x 109 platelets
STORED
• Up to 5 days at +20°C to +24°C (with agitation)
16. PC cont..
IN BAG
250-350 ml
DOSING
• 1 unit of platelet concentrate/10 kg (6bags); for an adult of 60‐70 kg
• single donor units containing 8 x 109 platelets should raise the platelet
count by 7000-10,000
• Increment will be less if there is splenomegaly, disseminated intravascular
coagulation (DIC) or septicaemia
PAEDS
10-20ml/kg
17. PC cont..
Administration:
• After pooling should be infused as soon as possible because
of the risk of bacterial proliferation
• Over a period of not more than 30 minutes
• Do not give platelet concentrates prepared from RhD
positive donors to an RhD negative female with
childbearing potential
• ABO compatible, whenever possible (NOT OBLIGATORY)
18. INDICATIONS
• Platelet function defects and thrombocytopenia often occur after cardiac bypass
surgery/antiplatelet medication
• Platelet transfusion is recommended for patients with bleeding not due to
surgically correctable causes (closure time provides global indication of platelet
function)
• Prophylactic platelet transfusions are not required for all bypass procedures
NON BLEEDING: <20,000
BLEEDING: <100,000
Platelet function is impaired in hypofibrinigenemia and Hct <30%. So use PRBC and
cryo to bring Hct >30%
Should not be transfused within 6hrs of loading dose and within 4hrs of maintainance
dose of clopidogrel
20. Fresh Frozen Plasma (FFP)
• FFP is plasma prepared from whole blood, either from the
primary centrifugation of whole blood into red cells and
plasma or from a secondary centrifugation of platelet rich
plasma
CONTENT
• Normal plasma levels of stable clotting factors, albumin,
immunoglobulin and Factor VIII at a level of at least 70% of
normal fresh plasma except factor V (66%), VIII (41%)
STORAGE
• Rapidly frozen to –25°C or colder within 8 hours of
collection, can be stored for upto 1yr
21. FFP cont..
IN BAG 200‐300 mL
Dosage: 2-4units (increase clotting factors by 10%)
PAEDS: 15 mL/kg
Administration:
• Should be ABO compatible
• Infuse as soon as possible after thawing
• Labile coagulation factors rapidly degrade; use
within 6 hours of thawing
22. FFP cont..
• Before use, it should be thawed in the blood
transfusion centre between +30°C and +37°C
• FFP can be thawed
Dry oven (10 minutes)
Microwave (2-3 minutes)
Water bath (20 minutes)
Thawed FFP can be used for up to 24 hours as long as it is
stored at 4ºC
Once out of the fridge, it must be used within 30 min
Once thawed should never be refrozen
23. INDICATIONS
• Dilutional effect of CPB and progressive loss of clotting factors in bleeding-can be given evn if INR is
high normal
• Patients with antithrombin III deficiency-heparin resistance
• Replacement of a single coagulation factor deficiency, where a specific or combined factor
concentrate is unavailable or contraindicated
• Immediate reversal of warfarin effect where prothrombin complex concentrate is unavailable
• In patients who are actively bleeding and whose INR is >1.5 (or POC equivalent)
• Massive blood transfusion
• Acute DIC if there are coagulation abnormalities and patient is bleeding
• Severe sepsis, particularly in neonates (independent of DIC)
24. COMPLICATIONS
• Acute allergic reactions are not uncommon,
especially with rapid infusions
• Severe life‐threatening anaphylactic reactions
occasionally occur
FFP for volume expansion can be avoided by using
crystalloid or colloid solutions
25. Cryoprecipitated anti‐haemophilic
factor (Cryo‐AHF)
• Cryo‐AHF is prepared from FFP by collecting the precipitate
formed during controlled thawing at +4°C and
re‐suspending in 10‐20 mL plasma
CONTENT
• Contains about half the Factor VIII and fibrinogen as a pack
of fresh whole blood: e.g. Factor VIII: 80‐100 iu; fibrinogen:
150‐300 mg, 40-70% von Willebrand factor, 50-1000 units
of factor XIII and 50-60mg fibronectin
STORED
• At –25°C or colder for up to 1 year
26. CRYO cont..
IN BAG
• One unit of 20 to 40 ml
• 5-6 units,100 to 200 ml
DOSE
1unit/10kg body wt
10units=fibrinogen increase by 70mg in 70kg man
PAEDS
10ml/kg
27. FORMULAE
• Blood volume=70ml/kg*wt in kg
• Plasma volume=BV *(1-Hct)
• Fibrinogen required(mg)=0.01*PV*(desired-
current)
• Bags of Cryo required=mg of fibrinogen
req/250mg
28. Administration
• ABO compatible product should be used (not
essential)
• After thawing, infuse as soon as possible
• Must be transfused within 6 hours of thawing
29. INDICATIONS
• Hypofibrinogenaemia due to major
haemorrhage and massive transfusion, vWD
• During major haemorrhage, fibrinogen should
be maintained > 1.5 g.l-1
• Combined liver and renal failure with bleeding
• Bleeding associated with thrombolytic therapy
• Disseminated intravascular coagulation with
fibrinogen < 1.0 g.l-1.
30. Leukoreduced PRBC
• Removing a proportion of the plasma from leucocyte
depleted whole blood or by leuco-depleting plasma
reduced red cells
• Non-LR RBC contain 1-3 x 109 WBC
• LR contain < 5 x 106 WBC and retains 85% of the
original cells
• HLA alloimmunization against class I antigens, febrile
reactions, and CMV infections
32. Irradiated PRBC
• PRBC units are exposed to gamma irradiation
(2,500 cGy) to damage donor WBC DNA
• Prevent a cellular immune proliferative response
to the recipient’s tissues
• Cesium-137 blood irradiators
• Irradiated within 14 days of donation and it then
has a shelf life of 14 days
33. Indications
• Transplant Recipients
• Intrauterine transfusion
• Immunosuppressed patients at risk for this
complication(GVHD)
• Neonates/Infants undergoing exchange
transfusion or ECMO
36. 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
37. MANAGEMENT
• Prolongation PT – FFP in a dose of 15 mL/kg
• APTT is also prolonged- Factor VIII/fibrinogen concentrate in
addition to FFP/ 10‐15 units of cryoprecipitate
• PCs only when
Clinical signs of microvascular bleeding
The patient’s platelet count falls below 50 x 109/L
Below 20 x 109/L, even if there is no clinical evidence of bleeding
The prophylactic use of platelet concentrates in patients receiving
large volume blood transfusions is not recommended.
40. Preservative solutions
CPD -21days
• Citrate is an anticoagulant,
• Phosphate serves as a buffer,
• Dextrose is a red cell energy source
CPDA -35 days
• Adenine allows RBCs to resynthesize adenosine
triphosphate (ATP), which extends the storage
time from 21 to 35 days
41. CHANGES DURING STORAGE
• RBCs metabolize glucose to lactate, hydrogen ions
accumulate, and plasma pH decreases
• 1° to 6° C stimulate the sodium potassium pump, and RBCs
lose K+ and gain Na
• The osmotic fragility of RBCs increases, and some cells
undergo lysis, resulting in increased plasma Hb levels
• Decreases in RBC concentrations of ATP and 2,3-
diphosphoglycerate (2,3- DPG)->leftward shift->decreased
offloading of oxygen
42. ADMINISTRATION OF BLOOD
PRODUCTS
When blood is transfused, it is important to keep detailed records including
the following in the patient’s notes:
Type and volume of each unit transfused
Unique donation number of each unit transfused
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
Record the time of completion of the transfusion
Identify and respond immediately to any adverse effect, by stopping the
transfusion
Record the details of any transfusion reaction
43. COMPATIBILITY TESTING
The laboratory performs COMPATIBILITY testing:
ABO and RhD grouping on patient and donors
Antibody screening on patient
Cross matching between serum of patient and
red cells of donor
44. CHECK POINTS
Blood bag should be checked for:
Haemolysis
Haemolysis on the line between the red cells and
plasma
Contamination, such as a change of colour in the
red cells, which often look darker/purple/ black
when contaminated
• Clot
• Leak
45.
46. DISCARDED
The blood unit must be discarded if:
• It has been out of the refrigerator for longer
than 30 minutes
• The seal is broken
• There is any sign of haemolysis, clotting or
contamination
47. Once issued by the blood centre, the transfusion
of whole blood, red cells, platelet concentrate
and thawed fresh frozen plasma should be
commenced within 30 minutes of removal from
the optimal storage conditions
48. IDENTIFY
• The patient must be positively identified-first
name, last name, date of birth and patient
identification number
• Check that the compatibility label attached to the
blood component has the same blood group and
14-digit component donation number (or batch
number for coagulation factors or SD FFP) as the
sticker on the blood component
• Check the expiry date and time
50. Time limits for transfusion
• There is a risk of bacterial proliferation or loss of function in
blood products once they have been removed from the
correct storage conditions
• Transfusion of a unit of blood should be completed within a
maximum period of four hours after removal from the
blood fridge: discard the unit if this period is exceeded
• If blood has been out of the blood bank refrigerator for
more than 30 minutes and is not transfused, then the unit
must be returned to the laboratory, where it will be
disposed of
51. Duration times for transfusion
Start transfusion Complete transfusion
• PRBC Within 30 minutes ≤ 4 hours
• PC Immediately Within 30 minutes
• FFP As soon as possible Within 30 minutes
• Cryoprecipitate As soon as possible Within 30 minutes
52. Blood administration set
• Use a new, sterile blood administration set
containing an integral 170‐200μ filter
• Change the set at least 12‐hourly during blood
transfusion
• In a very warm climate, change the set more
frequently and usually after every four units of
blood, if given within a 12‐hour period
• Priming with saline,D5 is hypotonic, RL contains
calcium
53. Monitoring the transfusion
• Before commencing the transfusion, it is essential to encourage the
patient to notify a nurse or doctor immediately if he or she
becomes aware of any discomfort such as shivering, flushing, pain
or shortness of breath or begins to feel anxious
• Ensure that the patient is in a setting where he or she can be
directly observed
For each unit of blood transfused, monitor the patient:
- Before starting the transfusion (baseline observation).
- 15 minutes after starting the transfusion.
- At least every hour during transfusion.
- Carry out a final set of observations 15 minutes after each unit has
been transfused
54. Warming blood
• There is no evidence that warming blood is
beneficial to the patient when transfusion is slow
Warmed blood is most commonly required in:
Large volume rapid transfusions:
- Adults: more than 50 mL/kg/hour
- Children: more than 15 mL/kg/hour
Exchange transfusion in infants
Patients with clinically significant cold agglutinins
55. Use of medication at time of
transfusion
• Not recommended to routinely use
pre‐medication like anti‐histamines,
steroids,mask or delay the signs and
symptoms of an acute transfusion reaction
and therefore delay recognition and action to
stop the transfusion
• Use a separate IV line if an intravenous fluid
has to be given at the same time as blood
transfusion
56. Use of fresh blood
Stored blood less than 7 days old is termed “fresh
blood”
Uses ( to avoid biochemical overload) to raise Hb:
- Renal and liver dysfunction
- Massive blood transfusion
- Raised plasma potassium
- Neonate requiring exchange transfusion
58. TRANSFUSION REACTION cont..
• With the exception of urticarial allergic and febrile
non‐haemolytic reactions, all are potentially fatal and
require urgent treatment
• The severity of the reaction and the degree of
morbidity is usually related to the volume of blood
transfused
The only sign in an unconscious or anesthetized patient
may be hypotension and uncontrolled bleeding or oozing.
In a conscious patient this may occur within minutes of
transfusion of as little as 5‐10 mL blood
60. Haemolytic transfusion reaction
• An acute haemolytic transfusion reaction is the result
of a mismatched blood transfusion, and causes acute
intravascular haemolysis
• Antibodies in the patient’s plasma haemolyse the
incompatible red cells
• Small volume (5‐10 mL) of incompatible blood can
cause a severe reaction
• Appear within minutes
61. Bacterial contamination and septic
shock
• Affects up to 0.4% of red cells and 1‐2% of platelet concentrates
• Pseudomonas species, grow at +2°C to +6°C and can survive or multiply in
refrigerated red cell unit
• Staphylococci grow in warmer conditions and are able to proliferate in PCs
which are stored at+20°C to +24°C
• Signs usually appear rapidly after starting infusion, but may be delayed for
a few hours
• Sudden onset of high fever, rigors and hypotension
• Urgent supportive care and high‐dose intravenous antibiotics are required
62. Transfusion Associated Circulatory
Overload
• Can result in heart failure and pulmonary
edema
• May occur when:
- Too much fluid is transfused.
- The transfusion is given too rapidly.
- Renal function is impaired.
63. Anaphylactic reaction
• Rare, risk is increased by rapid infusion, typically when fresh frozen plasma
is used
• IgA deficiency in the recipient is a rare cause of very severe anaphylaxis
• This can be caused by any blood product since most contain traces of IgA
Occurs within minutes of starting the transfusion and is characterized by:
- Cardiovascular collapse.
- Respiratory distress.
- No fever
Anaphylaxis is likely to be fatal if it is not managed rapidly and aggressively.
64. Transfusion Related Acute Lung Injury
• Caused by donor plasma that contains antibodies
against the patient’s leucocytes
• Rapid failure of pulmonary function usually presents
within 1‐4 hours of starting transfusion, with diffuse
opacity on the chest X‐ray
• No specific therapy
• Intensive respiratory and general support in an
intensive care unit is required
66. Delayed haemolytic transfusion
reaction
Signs appear 5‐10 days after transfusion:
Fever.
Anaemia.
Jaundice.
Occasionally haemoglobinuria.
Severe, life‐threatening delayed haemolytic
transfusion reactions with shock, renal failure and
DIC are rare
67. Post‐transfusion purpura
• This is a rare but potentially fatal complication of
transfusion of red cells or platelet concentrates, caused
by antibodies directed against platelet‐specific antigens
in the recipient
• Multigravida female patients
Signs and symptoms:
– Signs of bleeding.
– Acute, severe thrombocytopenia 5‐10 days after
transfusion, defined as a platelet count of <100 x 109/L.
68. MANAGEMENT
Management becomes clinically important at a platelet count
of 50 x 109/L, with a danger of hidden (occult) bleeding at 20
x 109/L.
• High dose corticosteroids
• High dose IV immunoglobulin, 2 g/kg or 0.4 g/kg for 5 days
• Plasma exchange
• Monitor the patient’s platelet count
• Platelet concentrates that are negative for the
platelet‐specific antigen against which the antibodies are
directed
• Recovery of platelet count after 2‐4 weeks is usual
69. Transfusion associated
graft‐versus‐host disease (TA‐GVHD)
• Fatal condition
Occurs in patients such as:
– Immuno‐deficient recipients of bone marrow transplants
– Immuno‐competent patients transfused with blood from individuals with
whom they have a compatible HLA tissue type, usually blood relatives
particularly 1st degree
Signs and symptoms typically occur 10‐12 days after transfusion and are
characterized by:
– Fever
– Skin rash and desquamation
– Diarrhoea
– Hepatitis
– Pancytopenia
70. TA-GVHD cont..
Management
• Treatment is supportive; there is no specific
therapy.
Prevention
• Do not use 1st degree relatives as donors, unless
gamma irradiation of cellular blood components
is carried out to prevent the proliferation of
transfused lymphocytes
71. Delayed complications: transfusion
transmitted infections
• HIV, Hepatitis B and C, syphilis (Treponema
pallidum), malaria
Cytomegalovirus (CMV)
Other TTIs include human parvovirus B19,
brucellosis, Epstein‐Barr virus, toxoplasmosis,
Chagas disease, infectious mononucleosis and
Lyme’s disease.
72. Duration of red-cell storage and complications after cardiac surgery.
N England J Med 2008 Mar 20;358(12):1229-39. Koch CG, et al.
In patients undergoing cardiac surgery,
transfusion of red cells that had been stored for
more than 2 weeks was associated with a
significantly increased risk of postoperative
complications as well as reduced short-term and
long-term survival.
73. Increased mortality, postoperative morbidity, and cost after red blood cell
transfusion in patients having cardiac surgery.
Circulation 2007 Nov 12 Murphy GJ, Reeves BC, Rogers CA,
Red blood cell transfusion in patients having
cardiac surgery is strongly associated with both
infection and ischemic postoperative morbidity,
hospital stay, increased early and late mortality,
and hospital costs.