importance of blood and blood components
DESCRIPTION
Educative and Informative.TRANSCRIPT
Importance of
Blood
And
Blood Component
Therapy By Dr Rashmi Sood Consultant Transfusion
Medicine delhi heart & lung
institute New Delhi.
Use of Blood and Blood Components
as a Medicine has come a long way!!!!
AIM OF Todays Programme
1) To create awareness of the vital role of
blood transfusion
in
saving lives
and
improving the health
of millions of people each year.
AIM OF Todays Programme
2) To motivate more people to
become REGULAR REPEAT
VOLUNTARY DONORS
so that no one suffers
for the want of blood.
THEME
MORE BLOOD MORE LIFE
NEED FOR BLOOD
In Delhi, need is about 4 lakh units of
blood every year and collection is
3.75 lakh units.
Majority of it comes from
replacement donors.
Voluntary donation is about 27
percent as compared to 45 percent
at the national level.
How much Blood do we have?
On average, an adult has about five to six liters
of blood in their circulation.
The total blood volume is based on body mass. Formula is 70 X Body Weight for MALES. 66 X Body Weight for FEMALES.
Blood in a person
E .g. A male of body weight 75 Kg has
75 x 70 =
5250ml or 5.25 litres of blood.
Why screen before Blood Donation????
For the safety of both
the donor
and
the potential recipient .
Who can Donate Blood?
Age : Between 18 to 60 years of Age.
Weight : At least 45 Kg.
Hemoglobin: 12.5gm%.
Frequency of Donations: Minimum interval between
donations is 3 months.
Health: In good health and feeling well.
Screening: At the time of donation a number of
questions are asked to determine donor eligibility.
1.Voluntary-non remunerated. 2.Replacement or relative.3.Professional or commercial.
62 countries in the world have entire collection Of blood by voluntary blood donation. In India approx. 50% is by Voluntary Blood Donation
Screening criteria
Medical history
Preliminary health check
Temporary Deferral
Permanent deferral
Tale of the red fluid called blood !!!!
The Three Formed Elements
What is BLOOD?
The fluid circulating throughout the body.
Carrier of carbon dioxide and oxygen
to and from the lungs.
Carries nourishment to the tissues.
And Takes away waste products to
Kidneys.
Components of Blood
The blood circulating is referred to as
‘Whole Blood’.
Whole Blood is made up of several different
components each with specific applications .
WHOLE BLOOD IS just a RAW MATERIAL
Red cells, white cells and platelets suspended in plasma as seen under MICROSCOPE
WHOLE BLOOD
VERSUS
COMPONENTS
Presently only 30-35 percent
blood is being used as separate
components .
It should increase
to
70-75 percent
each component is given
When specifically needed
Rationalizing the use of blood
and
preventing unnecessary wastage.
Imagine the outcome without the availability of these drugs!!!!
What are Red Cells?
Constitute the majority of cells in the blood.
Approximately a quarter of the cells in the human
body are red blood cells.
WHY RED IN COLOUR?
These cells' cytoplasm is rich in hemoglobin, an
iron-containing biomolecule that can bind oxygen
and is responsible for the blood's red color.
FUNCTION: Travel throughout the body,
deliver oxygen to tissues and remove
carbon dioxide to the lungs.
This role of the red cells (transporting
oxygen) is essential to prevent damage
to organs.
Where are Packed Red Cells used ?
Ask the parents of a thallesemic child.
Ask the family members of a kidney failure patient.
Ask the patients of severe anaemia (Whole Blood
Increases Chances of Circulatory Overload).
Ask the patients of Haemolytic Anaemia.
Packed Red Cells
Ask the patients undergoing Cancer
treatment(Hypoplastic and Aplastic
Anaemia).
Ask the patients undergoing
Cardiac surgery .
Ask the patients undergoing Knee replacement.
Ask the patients of Road accidents .
Packed Red Cells
Packed Red Blood Cells Contraindications!!
LRBC should not be used:
1) When anemia can be corrected with
specific medications, e.g., iron, B12, folic
acid, erythropoietin, etc
2) For volume replacement.
What are Platelets?
Platelets are colorless,irregularly shaped bodies found in blood.
Platelet Functions
The primary role of
platelets is to prevent
bleeding in injured
blood vessel walls by
forming an
aggregate at
the site of injury.
Platelet Functions
Platelets can also
participate in blood
coagulation,
inflammation
and wound healing.
Why platelets ? Can’t just fresh blood do the job ?
Ask a cancer Physician.
Ask a Physician treating patients with bleeding due to severely
decreased production or abnormal function of platelets , as in
Leukaemia
Hypoplastic Anaemia
Chemotherapy
Bone marrow transplantation
Marrow Infiltration eg. Carcinoma , Leukaemia
Drug induced or Radiation induced hypoplasia
Platelets
Ask a Physician treating bleeding
patients with platelet consumption or
dilutional thrombocytopenia
eg.Massive Transfusion with stored
blood.
Platelets
Can be given prophylactically to patients with rapidly
falling or low platelet counts, less than 10 x 109/L
(10,000/mL), secondary to cancer or chemotherapy.
Useful in selected cases of postoperative bleeding
with platelet count less than 50 x 109/L (50,000/mL).
Viral disease associated with Thrombocytopenia
eg.Dengue.
Platelets
Useful in functional platelet abnormalities.
PlateletsContraindications :
If bleeding is unrelated to decreased numbers
or abnormal platelet function.
In patients with consumption of endogenous
and exogenous platelets, such as in
Thrombotic Thrombocytopenia Purpura (TTP)
or Idiopathic Thrombocytopenia Purpura (ITP),
unless the patient has a life threatening
hemorrhage.
Platelets-Preparation:
Platelets are prepared from whole blood.
Platelets may also be obtained by
apheresis.
Platelets are suspended in a small
amount of the original plasma.
Platelet Incubator and Agitator
Need to be stored with constant agitation.
What are White Cells?
White blood cells travel throughout the body
and protect against bacteria and viruses.
There are different types of white blood cells
(granulocytes, macrophages and lymphocytes).
The lymphocytes help with immune defense.
White blood cells can also carry some viruses
and bacteria.
Who uses White cells ?
Easily obtained by
Granulocytapheresis.
Ask an intensive care physician who
is struggling to save a neutropaenic
patient refractory to all antibiotics.
What is Plasma?
Plasma is a protein-salt solution that acts
as a transportation medium for the other
blood components.
The red cells, white cells, and platelets are
suspended in the plasma.
Plasma is a straw colored clear liquid that
is 90% water.
Plasma-Functions
Plasma helps with clotting, fighting
infection, maintaining blood pressure
and immunity. In addition, it
contains minerals (e.g., sodium and
potassium).
Plasma-Preparation
Fresh frozen plasma is separated
from whole blood and frozen within 8
hours of collection (approx. 250 mL).
It can also be obtained from by
apheresis (approx. 500 mL).
Can’t one just use fresh blood?
Ask a physician involved in the care
of a cirrhotic patient
Ask a Transfusion specialist wishing
to do an exchange on a young TTP
patient
Fresh Frozen Plasma (FFP)Function:
Fresh frozen plasma contains the clotting
factors that are necessary for hemostasis.
Plasma also has volume expansion and
oncotic properties.
Fresh frozen plasma contains a normal
concentration of fibrinogen and the labile
coagulation factors VIII and V.
Fresh Frozen Plasma Indications :
1.In bleeding patients with multiple
coagulation factor deficiencies
secondary to liver disease,DIC and massive
blood transfusion.
2.Patients on anticogulant
drugs like Warfarin sodium
and Dicumarol are deficient in
Indications
functional Vit.K dependent coagulation factors
II,VII,IX
and X.If these patients are bleeding or need
emergency surgery.
3.FFP is used in antithrombin deficiency,inherited
or acquired after oral contraceptive use or in
patients with liver disease.
Indications
4.FFP is used in infants with secondary immunodeficiency
associated with severe protein losing enteropathy .
5.FFP is used in patients who have to undergo emergency
bypass surgey and are on anticoagulants.
6.FFP is indicated for massive transfusion (replacement of the
patient’s blood volume in < 24 hours) with a
demonstrated deficiency of Factor VIII and V, otherwise
frozen plasma is adequate.
Indications
7.Fresh frozen plasma is indicated in
exchange transfusion in neonates.
Cryoprecipitate (Cryo):
Cryo is prepared from fresh frozen plasma.
A source of coagulation factors :
• Factor VIII : In acquired deficiency eg DIC , massive
transfusion and congenital deficiency as in Hemophilia A.
• Factor V, Factor XIII.
• Von Willebrand Factor in Von-Willebrands disease.
Fibrinogen and fibronectin are present in Cryo.
Cryo can be used to make fibrin glue.
Cryoprecipitate (Cryo)
What is an Apheresis Donation?
Apheresis means to selectively collect
a blood component
(red cells,
platelets,
white cells
or plasma)
Platelets Plasma
Principle of APHERESIS Donation
A specific blood component
is selected
and
separated
by the machine
(most commonly platelets or plasma)
Advantages :
The components that are not
required are returned to the donor.
Relatively large amounts of the
single component can be selectively
collected.
PLASMA EXCHANGE &RED CELL exchange
1) Therapeutic Plasma exchange
indicated in Myasthenia crisis , Guillain Barre
Syndrome, Thrombotic thrombocytopaenic
purpura, Haemolytic uraemic syndrome etc.
2) Red cell exchange for falciparum
malaria,sickle cell anaemia.
Irradiated blood components
Prevents Transfusion Associated Graft vs. Host Disease.
Irradiation for:
– Units from blood relatives
– Allo/Auto Hematopoietic Progenitor Cell Transplant
Recipients
– Intrauterine transfusion
– Neonates undergoing exchange transfusion
– Hodgkin’s Disease
– Cellular immune deficiency disorders
– Solid Organ Transplants
FRACTIONATED PLASMA PRODUCTS
INCLUDE :
1) ALBUMIN HUMAN SERUM ALBUMIN
2) PLASMA PROTEIN FRACTION
3) IMMUNOGLOBULINSIMMUNE SERUM GLOBULINSPECIFIC Igs (HYPER IMMUNE)
4) COAGULATION PROTEINSF VIII,IX, VIIACTVATED F IX COMPLEX/ F VIII
5) PROTEASE INHIBITORSAT III, CI ESTERASE INHIBITOR
RECOMBINANT BLOOD PRODUCTS:
1)Recombinant factor VIII e.g. Recombinate
2)Recombinant factor IX e.g. Benefix
3) Recombinant factor VII (Novoseven)
4) vWF, ATIII
5) Alpha1 protease inhibitor
6) Hb vaccines
7) R Hb
8) Haemopoietic growth factors
EPO,G-CSF, GM-CSF,TPO,ILs,TNF
THANK
YOU…….