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| Blood transfusion |
Blood transfusion
Bld infused as whole bld or component infusion.1>packed red cells-
a> increse o2 carrying capacity of bld
b> improve platelet function
c> 1 unit rbc-rise in hb of 1g/dl in adult
Indication 4 rbc transfusion
a> symptomatic anaemia,bleding patient
b> hb <7 g/dl
c> hb <10g/dl in acute MI,CHf,angina tia,syncope
d> hb<8 g/dl in thalasemia
2>platelet rich plasma-
a> when bleding due 2 reduced platelet or inadeqate platelet function
b> 1 PRP increases plate count by 4000-8000/mm3
c> Abo matching required
indication 4 platelet tranfusion-
a> microvascular bleding due 2 thrombocytopenia
b> thrombocytopenia wth risk of haemorrage
c> surgical procedure.
C/I
a>thrombotic thrombocytopenic purpura
3>fresh frozen plasma
ABO matching required Rh compactibility not required.
Indication-
a> factor 5 n 11 def
b> dilutional coagulopathy
c> coagulopathy of liver diseses
d> HELLP Syndrome e>reversal of warferin anticoagulation
4>cryoprecipitate
indications
a> factor 8 def
b> von willebrand disease
c> hypofibrinogenemia wth <100 mg/dl c>factor 13 def
COMPLICATION-
a> immunological reaction-
1> acute haemolytic transfusion reaction-due 2 incompatible donor red cells
C/F-fever chills back pain pruritus burning sensation hypotension shock oliguria Management -
a> stop tranfusion
b> change BT set
c> physical exam wth BP Urine output
d> wthdraw bld fm oposite arm n send 4 screening
e> if hypotension administer fluid
f> add frusemide
2>febrile non haemolytic reaction
a> due 2 antileucocytic Ab in pregnant pt
b> due 2 cytokines in stored platelet
3>urticaria
due 2 prence of Ab in recipient bld 2 infused plasma protein
4>anaphylaxis
In pt wth Ab against IgA
5> tranfusion related acute lung injury-
a>donar plasma has Ab 2 pt lecocytes
b>pt devel acute resp reaction wth fever cough shortnes of breath
6>delayed haemolytic tranfusion reaction-3 -21 day after tranfusion
7>tranfusion asso graft vs host disease-a>due 2 immune reaction of donor T cells
C/f
fever skin rash liver n renal failure n pancytopenia
8> post tranfusion purpura-
a> imune mediated thrombocytopenia
b> 5-12 day after transfusion
NON IMMUNE reaction
a> circulatory overload
b> air n fat embolism
c> thrombophlebitis
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