2. Types :
1. Hetrologous :
O Transfusion of blood from one person to other
person.
2. Autologous :
O Transfusion of blood from one person to the
same person.
3. Indication :
1. After Haemorrhage (bleeding) :
O Acute blood loss (sever Hge)→hypotension or shock.
2. Sever anemia (Hb = 7 or less ).
3. Hemophilia bleeding and other familial disorder.
O Hemophilia ( 85% ↓ factor VIII )or IX or XI .
4. Purpura (↓plate.)(thrombocytopenia).
5. Leukopenia (↓WBC).
6. Chronic leukemia (↓bone marrow production ).
7. Hypoproteinemia (↓albumin).
8. Sever infection (septicemia).
9. Major trauma (major surgeries or burns ).
4. Function of blood :
1. Major transport medium for :
(nutrition–O2–temperature–wast product–hormones–enzymes)
2. Defense or protect mechanism by WBC .
3. Blood clotting.
4. Regulation of acid base balance (PH):
O Arterial PH = 7.4.
O Venous PH = 7.36.
Note: Respiration and renal also regulated PH.
5. Regulation of water balance .
O (hormonal “ADH & aldosterone” , thrist center and renal )
6. Blood fraction :
1. Packed RBC (red cell concentrate).
Use in :
O Anemia (chronic) .
O Elderly .
O To reduced overload in cardiac patient.
o It stored for 35 days at 1-6 Co
.
7. Blood fraction :
2. Fresh frozen plasma (FFP).
Use in :
O Low protein & burn & hypoalbuminaemia.
O Coagulation disorder as hemophilia.
O Liver failure , cirrhosis.
O Massive transfusion.
O DIC.
O Revers the does of warfarin preoperative.
O Sever bleeding.
O ↓vitamin K .
o It stored for 2 years at - 40 C
o
.
o Dose 15 ml/kg.
8. Blood fraction :
3. Cryoprecipitate (prepared from FFP)
OWhen FFP thaws at 4C
o
=> white
supernatant layer it called Cryoprecipitate.
OContain factors VIII ,XIII, fibrinogen,
vonwillebrand’s factor.
9. Blood fraction :
4. Platelet (normal platelet in body = 150,000 – 450,000 )
Use in :
O Thrombocytopenia.
O Drugs induced hemorrhage ( aspirin – clopidogrel).
O In massive blood transfusion.
o 1 unit of platelet => ↑ platelet in blood abut 10,000
10. Notes :
1. Donor age > 18 years old.
2. Donor weight >45 kg.
3. In stored blood :
O Temp. at 2 – 6 C
o
.
O RBC last for 3 – 5 week.
O WBC rapid destroyed & platelet 5–7 day.
O Citrate bind with Ca++
=>↓Ca++
O ↓f VIII & V in 1st week 60 – 80 %.
O ↑H+
O Rapid transfusion => jaundice and fever after 1 week.
O Deylad transfusion >6hours lead to contaminated with bacteria
O Massive transfusion :
O Cold transfusion + blood loss => hypothermic coagulopathy (bleeding).
O ↓platelet,,↑K+
and ↓Ca++
11. Complication of blood transfusion :
1. Immunological reactions :
A. Hemolytic reaction (may killed)=> DIC (start in 1st 0.7ml Ag –Ab reaction to ABO
incompalibility .
O C/F
O ↓BP
O Chest pain with restlessness.
O Fever with chill.
O Jaundice
O Dyspnea
O IV set pain & oozing.
O R/
O Stop transfusion.
O IV fluid
O Diuretic (osmotic)
O Corticosteroid .
12. Complication of blood transfusion :
1. Immunological reactions :
B. Allergic reaction => anaphylactic shock (due to protein
allergic )
OC/F
OItching .
OUrticaria.
OLaryngeal edema => dyspnea .
13. Complication of blood transfusion :
2. Congestive heart failure (CHF):
O Due to massive transfusion (more in elderly, pregnant &cardiac
disease ).
3. Transmission of infection :
O (HBV, HCV, HIV, Malaria)
4. Electrolyte imbalance.
5. Citrate intoxication
O ↓Ca++
so give 10ml Ca++
for 2 units blood.
14. Complication of blood transfusion :
6. Air embolism.
7. Transfusion related acute lung injury (TRALI)
O Ab – Ag reaction => (ARDS)
8. Thrombophlebitis .
9. Massive transfusion complication :
O Hypothermia => coagulopathy.
O ↓Ca++
=> convulsion.
O ↑K+ => cardiac arrest.
O DIC
O ARDS
O ↓platelet => sever bleeding.
