DEPARTMENT OF ORTHOPAEDICS

Indication and Types of Blood

Transfusion
PRESENTER: DR. GOWTHAM G
MODERATOR: DR. PRABHU E
 LESSON PLAN
 Name of the presenter: Dr. Gowtham G
 Date: 05/07/2022
 Time: 8 min
 Subject: Orthopaedics
 Topic: Indication and types of blood transfusion.
 SPECIFIC LEARNING OBJECTIVES

At end of the class all participants should be able to know:

• What are all the indications of blood transfusion?
• What are all the types of blood transfusion ?
 INTRODUCTION

• Blood is a liquid connective tissue of the body.

• Average blood volume in,
• Male - 70 ml per kg body weight.

• Female - 66 ml per kg body weight.

• Children - 85 ml per kg body weight.

• Pregnant women -100 ml per kg body weight.

• Blood/ blood components should be used only if other mode of therapy
eg. crystalloids and colloids have proven ineffective and if the benefits of
blood transfusion over weights risk associated with it.
 Indications

• Pre-operative hemoglobin is the strongest risk factor for postoperative

blood transfusion.

• Longer procedures with anticipated blood loss of > 15% of blood volume.
• Hematocrit <24%.
• Patient on Chemo therapy/ Radio therapy.
• Anemia- transfusion should especially be considered at hemoglobin <8
g/dL and/or if patient is symptomatic.

• Tachycardia unresponsive to fluids.

• Trauma – Massive hemorrhage – hypovolemia with or without shock.
• Bleeding disorders like haemophilia, thalassemia major etc.
 Autologous Transfusion

• Autologous transfusion is collection and subsequent re-infusion of patients own

blood or blood component.

• Types,
• Pre operative/ pre deposit (leap frog technique)

• Acute isovolemic/ Normovolemic haemodilution

• Intra operative blood salvage.

• Post operative blood salvage.

 Allogenic Transfusion
• Transfusing donor blood/ blood products to recipient of same species.
• Types,
• WHOLE BLOOD
• PRBC
• PLATELETS
• FFP
• PLATELETS
• CRYO PRECIPITATE
 Massive blood transfusion
• Transfusion/infusion of whole blood equal to or exceeding the persons
blood volume within 24 hours period
• Transfusion of 10 unit of whole blood (450ml each) or 20 units of PRBC
in 24 hours
• Replacement of more than 50% of blood volume in 3-4 hours in adult.
• Indications
• Medical emergency eg. GI bleed, ectopic pregnancy.
• Major surgeries eg. Transplant surgeries
• FAST positive
• SBP of less than 90, heart rate of > 120
• Penetrating mechanism of trauma
 USES OF BLOOD PRODUCTS
• Increase oxygen carrying capacity
• Volume expansion
• Whole blood
• PRBC
• Increase protein levels
- Fresh frozen plasma
- Albumin
• PROVISION OF COAGULATION FACTORS
- Cryoprecipitate
- Fresh whole blood
- Fresh frozen blood

• INCREASE OF PLATELETS
- Platelet concentrate
- Fresh whole blood
 WHOLE BLOOD

• Indications: massive blood loss, trauma, exchange transfusion

• Contra indications: Risk of volume overload in patients with Chronic
anaemia, Cardiac failure.
 FRESH FROZEN PLASMA :

• Contains all soluble coagulation factors

• Indications: Urgent reversal of warfarin therapy, correction of known
coagulation factor deficiencies, correction of bleeding with elevated PT,
APTT and after massive transfusion, Antithrombin III deficiency.
 PLATELETS

• Indications: Severe thrombocytopenia <5000/UL, thrombocytopenia with

clinical bleeding or during chemo/radiotherapy and transplantations

• Contra-indications : Autoimmune thrombocytopenia, thrombotic

thrombocytopenic purpura.
 CRYO-PRECIPITATE

• Contains high levels of factor 8 and Fibrinogen – used for the treatment of
haemophiliacs and von Willebrand's disease and in DIC.
 Reference
• MAKROO PRINCIPLES AND PRACTICES OF TRANSFUSION
MEDICINE 2ND EDITION.
THANK YOU