blood & blood products

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  • 1.Blood & Blood Products S.Laxiny Medical Student FHCS EUSL

2. Blood- Whole Blood FreshWhole Blood Blood Products Cellular Components- Red Cell Concentrates Platelet Concentrates Granulocyte Concentrate Plasma Components- Fresh Frozen plasma Cryoprecipitate Cryopoor plasma Stored plasma Plasma Derivatives- Albumin Immunoglobulin Coagulation Factors 3. Transfusion practice in Paediatrics For transfusion purpose,there are two groups of children 1.Neonates and infants 4 months and children Neonates and infants 4 months & children- Blood grouping Antibody screening Cross matching 4. Blood volume Premature baby 100ml/kg Full term baby85ml/kg Infant72ml/kg Children76ml/kg Adults80ml/kg 5. Hemoglobin concentration in children AgeHb concentration g/dl Cord blood+16.5 Day 1+18.0 1 month+14.0 3 months+11.0 6months-6 years+12.0 7-13 years+13.0 Amount to be transfused must br carefully calculated, 6. Whole Blood (WB) 7. Whole Blood (WB) Whole blood=Donor blood + Anticoagulant 1 Unit-450ml Anticoagulant (CPDA-1)-63ml No functional platelets No labile coagulation factors WB is used for component preparation. Hct-45% Stored at 2-6 0 cShelf life-35 days 8. Whole Blood Mandatory screening tests HBsAg Anti-HCV Anti-HIV 1 & 2 VDRL/ TPPA Malarial Parasite 9. Fresh Whole Blood Packed Red Cells Light spin,22 o C(within8hrs) Platelet Rich Plasma Platelet Concentrate Fresh Plasma Store at 22 o C Freeze(FFP) Heavy spin,22 o C 10. Preparation of blood components from wholeBlood 11. Whole Blood Indications Acute blood loss with hypovolaemia Exchange transfusion-severe anaemia at birth severe hyperbilirubinaemia Massive transfusion Cardiovascular bypass surgery 12. Whole Blood Risk of volume overload:Chronic anaemia Cardiac failure Dose of blood transfusion -20ml/kg Increase Hb by 1 g/dl Rate of Blood Transfusion -3ml/kg/hr Transfusion considerations -ABO compatible Cross match compatible Start transfusion slowly 13. Whole Blood Potential Adverse Effects Reactions-Haemolytic FebrileAllergic Anaphylactic Infectious diseases Sepsis Circulatory overload TA-GVHD TRALI 14. Fresh Blood Blood < 5 days Source of coagulation factors, platelets& WBC Blood 10% of total blood volume. 20. Guidelinesfor Paediatric red cell transfusions Infants >4 months & children Acute loss > 25% circulating blood volumeHb < 8.0 g/dL in perioperative periodHb < 13.0 g/dL and severe cardiopulmonary diseaseHb < 8.0 g/dL and marrow failureHb < 8.0 g/dL and symptomatic chronic anemia 21. Red Cell Concentrates Autoimmune hemolytic anaemia RCC to prevent coronary insufficiency, congestive heart failure, cardiacdecompensation or neurological impairment. Transfusion may stimulate autoantibodyproductioncomplicating subsequent transfusion. 22. Red Cell Concentrates Thalassemia Periodic regular blood transfusions Every3 or 4 weeks Rate 2-3 hours/unit Pre transfusion Hb level -9-10g/dl Post transfusion Hb shouldnot rise >14g/dl 23. Red Cell Concentrates Thalassemia Annual blood consumption=total blood transfused over 12 months/patiens weight in middle of the year. If blood consumption is >200ml/kg BWspleenectomy should be considered 24. Sickle cell disease Indications for simple top up transfusion Severe anaemia Splenic or hepatic sequestration Aplastic crisis Indications in surgery Organ transplantation Eye,major abdominal surgery Dont raise >10g/dl=raise viscosity 25. Red Cell Concentrates Dose of blood transfusion -10ml/kg cardiac failure -3-5ml/kgIncrease Hb by1 g/dl Rate of Blood Transfusion-3ml/kg/hr Adverse effects:Same as Whole blood 26. Leucoreduced Red Blood Cells Most plasma & 70-80% WBC(buffy coat)removed &100ml ofAS added. Indication Symptomatic anaemia Suitable for patients requiring repeatedtransfusions. Prevent febrile non haemolytic reactions. 27. Leucoreduced Red Blood Cells WBC :

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