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Blood transfusion therapy RENE PSA MENDOZA, MD, MHSA Associate Professor, Department of Surgery FEU-NRMF Institute of Medicine
Functions and Properties of Blood ,[object Object],[object Object],[object Object]
Functions of Blood ,[object Object],[object Object],[object Object],[object Object],[object Object]
Functions of Blood ,[object Object],[object Object],[object Object],[object Object]
Functions of Blood ,[object Object],[object Object],[object Object],[object Object]
Fluid compartments ICF ECF Interstitial  Plasma Capillary Membrane Cell Membrane ~ 15% of  body weight ~ 40% of  body weight ~ 5% of  body weight
Blood volume ,[object Object],~ 5% ~ 2-3% of body weight  +
Banked Whole blood ,[object Object],[object Object],[object Object]
Banked Whole blood ,[object Object],[object Object]
Banked Whole blood ,[object Object],[object Object],[object Object],[object Object]
Changes in rbc  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Changes in rbc ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fresh whole blood ,[object Object],[object Object],[object Object]
Blood Component Therapy ,[object Object],[object Object],[object Object]
Packed red cells ,[object Object],[object Object],[object Object],[object Object],[object Object]
Packed red cells ,[object Object],[object Object],[object Object],[object Object]
Packed red cells ,[object Object],[object Object],[object Object],[object Object]
Packed red cells ,[object Object],[object Object]
Frozen red cells ,[object Object],[object Object],[object Object],[object Object],[object Object]
Platelet concentrates ,[object Object],[object Object],[object Object]
Platelet concentrates ,[object Object],[object Object],[object Object]
Platelet concentrates ,[object Object],[object Object],[object Object],[object Object]
Fresh frozen plasma ,[object Object],[object Object],[object Object]
Fresh Frozen Plasma ,[object Object],[object Object],[object Object],[object Object]
Cryoprecipitated antihemophilic factor ,[object Object],[object Object],[object Object]
Cryoprecipitated antihemophilic factor ,[object Object]
Replacement therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Serologic compatibility
Rh groups ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Parameter Class I Class II Class III Class IV blood loss in mL <= 750 mL 750 − 1,500 mL 1,500 − 2,000 mL >= 2,000 mL blood loss as % TBV <= 15% 15 − 30% 30 − 40% >= 40% pulse > 100 > 100 > 120 >= 140 blood pressure normal normal decreased decreased capillary refill normal delayed delayed delayed respirations 14 − 20 20 − 30 30 − 40 > 35 urine output >= 30 mL/h 20 − 30 mL/h 5 − 10 mL/h minimal mental status slightly anxious mildly anxious anxious and confused confused and lethargic
[object Object],[object Object]
Risks from a unit of ordinary red cells ,[object Object],[object Object],[object Object],[object Object]
Transfusion reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transfusion reactions ,[object Object],[object Object],[object Object]
Allergic / urticarial transfusion reactions ,[object Object],[object Object]
Allergic / urticarial transfusion reactions ,[object Object],[object Object],[object Object]
Allergic / urticarial transfusion reactions ,[object Object],[object Object],[object Object]
Hemolytic Reactions ,[object Object],[object Object],[object Object]
Immediate hemolytic transfusion reaction ,[object Object],[object Object],[object Object]
Clinical presentation ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Clinical presentation
Renal toxicity ,[object Object],[object Object]
DIC ,[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
patient’s identification checked.. ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Laboratory criteria  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Delayed hemolytic transfusion reactions  ,[object Object],[object Object],[object Object]
Delayed hemolytic transfusion reactions ,[object Object],[object Object]
Clinical presentation ,[object Object],[object Object]
Delayed hemolytic transfusion reactions ,[object Object]
Febrile nonhemolytic transfusion reaction ,[object Object],[object Object],[object Object]
Febrile transfusion reactions ,[object Object],[object Object],[object Object]
Bacterial contamination  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Bacterial contamination ,[object Object],[object Object],[object Object],[object Object]
Bacterial contamination ,[object Object],[object Object]
Bacterial contamination ,[object Object],[object Object],[object Object]
Transfusion Related Acute Lung Injury (TRALI) ,[object Object],[object Object],[object Object]
Transfusion Related Acute Lung Injury (TRALI) ,[object Object],[object Object],[object Object]
Clinical presentation ,[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object]
Electrolyte toxicity (i.e., potassium) ,[object Object],[object Object],[object Object]
Hypothermia ,[object Object],[object Object],[object Object]
Overtransfusion  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Transmission of diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transmission of diseases ,[object Object],[object Object],[object Object],[object Object]
Pathogen Inactivation Technology ,[object Object],[object Object],[object Object]
Pathogen Inactivation Technology ,[object Object]
Pathogen Inactivation Technology
Indications for blood replacement ,[object Object],[object Object],[object Object]
What are the indications for RBC transfusion in the critically ill surgical patient? ,[object Object],[object Object]
..  indications for RBC transfusion  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Volume replacement ,[object Object],[object Object],[object Object],[object Object],[object Object]
Blood loss of 1L in a healthy adult ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
RBC Infusion   ,[object Object]
Platelet Infusion   ,[object Object]
FFP Infusion   ,[object Object],[object Object]
[object Object]
PACKED RED CELLS ,[object Object],[object Object],[object Object],[object Object]
FRESH FROZEN PLASMA ,[object Object],[object Object],[object Object],[object Object]
PLATELETS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Platelet concentrates ,[object Object],[object Object],[object Object],[object Object],[object Object]
CRYOPRECIPITATE ,[object Object],[object Object],[object Object],[object Object],[object Object]
major indication for whole blood transfusion ,[object Object],[object Object]
Massive transfusion ,[object Object],[object Object],[object Object]
Massive transfusion ,[object Object],[object Object],[object Object],[object Object]
Massive transfusion ,[object Object]
O negative blood ,[object Object],[object Object],[object Object]
O+ blood ,[object Object],[object Object],[object Object]
Massive transfusion complications ,[object Object],[object Object],[object Object]
Massive transfusion complications ,[object Object],[object Object],[object Object],[object Object]
Massive transfusion complications ,[object Object]
Transfusion options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods of administering blood ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods of administering blood
Special concern ,[object Object],[object Object]
Blood transfusion therapy Raymund AG Ong, MD FPCS FPALES  Department of Surgery FEU-NRMF Medical Center

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Blood Transfusion

  • 1. Blood transfusion therapy RENE PSA MENDOZA, MD, MHSA Associate Professor, Department of Surgery FEU-NRMF Institute of Medicine
  • 2.
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  • 6. Fluid compartments ICF ECF Interstitial Plasma Capillary Membrane Cell Membrane ~ 15% of body weight ~ 40% of body weight ~ 5% of body weight
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  • 32. Parameter Class I Class II Class III Class IV blood loss in mL <= 750 mL 750 − 1,500 mL 1,500 − 2,000 mL >= 2,000 mL blood loss as % TBV <= 15% 15 − 30% 30 − 40% >= 40% pulse > 100 > 100 > 120 >= 140 blood pressure normal normal decreased decreased capillary refill normal delayed delayed delayed respirations 14 − 20 20 − 30 30 − 40 > 35 urine output >= 30 mL/h 20 − 30 mL/h 5 − 10 mL/h minimal mental status slightly anxious mildly anxious anxious and confused confused and lethargic
  • 33.
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  • 100. Blood transfusion therapy Raymund AG Ong, MD FPCS FPALES Department of Surgery FEU-NRMF Medical Center