Professional Documents
Culture Documents
Blood Product
Blood Product
Mallika Sinha
Moderator
DR. VINOD KUMAR
Introduction
• Blood transfusion is a double edged sword, thus
transfuse only when benefits outweigh the
risk.
• Restricted availability is the major limiting
factor hence, use of blood component improve
the overall economy of blood.
• Most of the associated complications are
preventable!!
Whole Blood
• Description - Increase haemoglobin by 1%
No functional platelets
No labile coagulation factors
• Indications
– Acute blood loss with hypovolemia
– Exchange transfusion
– Red cell transfusion when red cell
concentrate/suspensions are not available.
• Contraindication
– Chronic anemia
– Incipient cardiac failure
Whole Blood
• Risk : Capable of transmitting any agent present in cells
or plasma not detected by routine screening.
• Storage : Between +20C to +60C
35 days with CDPA.
• Administration
– Must be ABO and Rh compatible
– Transfusion should be started within 30 minutes .
– Transfusion should completed within 4 hours of starting.
– Medication should never be added to blood.
Whole Blood
• Effects of storage
↓ PH
↑ K+
↓ 2,3DPG
↓ Platelets, platelet function lost by 48 hours.
↓ Coagulations factors (V & VIII)
Adverse effects of transfusion
• Acute complications
– Within 24 hours of transfusion
1. Mild reaction
2. Moderately severe reaction
3. Life threatening reactions
• Symptoms –
– Pruritus (itching):
• Possible cause –
– Hypersensitivity (mild):
Adverse effects of transfusion
Category 2 – Moderately severe
• Signs –: Flushing, Urticaria, Rigors, Fever,
Restlessness, Tachycardia
• Symptoms – Anxiety, Pruritus, Palpitation,
Mild Dyspnoea, Headache
• Possible cause –
Hypersensitivity (moderate - severe)
Febrile non haemolytic transfusion reactions:
1. Antibodies to WBC & Platelets.
2. Antibodies to proteins including IgA
Possible contamination with pyrogens and/or bacteria
Management of Moderately Severe Reaction
Stop transfusion
↓
Maintain vitals
↓
Antihistamines
↓
Corticosteroids + bronchodilators
(if anaphylactoid features)
↓
If clinical improvement
↓ Yes No ↓
Restart Treat as category 3
Adverse effects of transfusion
Category 3 – Life threatening reaction
• Signs –: Rigors, Fever, Restlessness, Tachycardia (>20%),
Hypotension (>20%), Haemoglobinuria, Unexplained bleeding
(DIC)
• Symptoms – Anxiety, Chest Pain, Pain near infusion site,
Respiratory distress, Loin/Back pain, Dyspnoea, Headache.
• Possible cause –
Acute intravascular haemolysis
Bacterial contamination and septic shock
Fluid overload,
Anaphylaxis,
Transfusion associated lung injury.
Management of Life threatening reaction
Stop transfusion
↓
Maintain vitals / airway / oxygen
↓
adrenaline
↓
Diuretics
↓
Corticosteroids + bronchodilators
(if anaphylactoid features)
Management of Life threatening reaction contd…
• Advantages–
– Adequate adult dose from single donor.
– Reduced donor exposure
– Reduced bacterial contamination, specially in platelets
– Low chances of refractoriness to blood components.
Irradiated Blood Components