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Blood transfusion :cherry_blossom: (Blood component :blossom: (:sunflower…
Blood transfusion :cherry_blossom:
Blood component
:blossom:
:sunflower:
1. Whole blood
Sizes in Thailand:
350, 450 ml
Blood from donor 450 ml + Blood anti-coagulant so
1 unit
=
500 ml
and Hb 12 g/dl
Lacks F5, F8 (labile factor)
I/C
:check:
Replace RBC in Acute blood loss
Exchange transfusion
:sunflower:
2. Packed Red Cell
:flower_playing_cards:
Packed red cell (PRC)
1 unit = 150-330 mL = Hb 20 g/dL
From Whole blood 1 bag ➯ ปั่นแยก into PRC
I/C
:check: - Symptomatic anemia (eg Thalassemia)
Dose:
10 ml/kg
:flower_playing_cards:
Leucocyte Reduced Red cell
I/C
:check:
:arrow_down: rate of getting
Febrile non-hemolytic transfusion reaction
(LPRC & LDPRC)
:arrow_down: rate of CMV infection (CMV is found in WBC) (LDPRC)
:arrow_down: rate of Human leukocyte Ag
alloimmunization
(LDPRC)
Types
:pig2:
:pig:
Leukocyte Poor PRC
(L
P
RC)
1 unit = 200-350 mL
Amount of WBC < 1.2 x 10^9 cell/bag
:pig:
Leukocyte Depleted PRC
(L
D
PRC)
Amount of WBC < 5 x 10^6 cell/bag
LDPRC 1 unit = Plt conc 6 unit
:postbox:
Storage
Prestorage: Filter before store
within 24 hrs after donate
Post storage: Filer
after
donate for
24 hrs
ALL
(PRC/LPRC/LDPRC) kept at
1-6 °C
:sunflower:
3. Platelet concentrated
:small_orange_diamond:
Platelet concentrated (PC)
Prep fr: ปั่นแยก Whole blood
Plt 1 unit = 50-60 mL = 0.5 x 10^11 cell
:small_orange_diamond:
Single donor plt concentrated (SDP)
Prep fr: Aphresis
= 3 x 10^11 cell
I/C
:check:
Treat bleeding fr Low plt or Plt dysfunction
Prevent bleeding fr Low plt
Acute leukemia keep < 10,000
Acute leukemia
with fever
keep < 20,000
Lumbar puncture keep > 50,000
Major Sx keep > 100,000
:star::star2:
Plt 0.1 unit/kg
➯ :arrow_up:
Plt 20,000-40,000/mm3
:star::star2:
:star::star2: storage at
20-24°C
can keep for
5 days
:question: How long does each blood products last?
PRC lasts 1 month
Plt lasts 5 days
FFP lasts
:sunflower:
4. Fresh frozen plasma
Prep fr: Plasma ที่ได้จากปั่นแยก Whole blood & freeze at -18°C
Coagulation factors
ครบ
I/C
:check:
Replace loss of coagulation factor*
Exchange transfusion (in newborn)
Hemophilia
DIC
Massive blood transfusion
TTP
Doses depend on Type of coagulation factor
(eg FFP 1 mL ➯ raise Factor VIII activity 2%
:question:Drip rate for each blood products?
PRC drip in
4 hr
Plt drip in
30min - 1hr
(do not exceed 1 hr)
FFP drip rate <
2 hr
:sunflower:
5. Cyroprecipitate
Prep fr: Thaw FFP ➯ then, ปั่นตะกอนแยก at 4°C ➯ then, freeze at -18°C
Contains Factor VIII, XIII, VWF, Fibrinogen
I/C
:check:
Hemophilia A, VWD
DIC replace fibrinogen
Doses
: 0.2 unit/kg/dose
:star::star2:
after thaw
Cyro only
lasts 4 hrs
& no need to give same blood group of Cyro
Others
Red blood cell
Ab
Natural
occurring Ab :
ABO
:umbrella_on_ground:
IgM
Causes reaction at BT 4-22°C
Agglutination RBC
Hemolytic transfusion reaction
Immune Ab :
Rh
:closed_umbrella:
Ig
G
(so it can passes placenta)
Causes reaction at BT
37°C
No
Agglutination RBC
Caused by receiving other ppl’s RBC
:umbrella_on_ground:
ABO
blood group
Select
same
blood group
Case
cannot use same blood group
➯ PRC or Plasma
Plt given in children — same thinking as Plasma
(receive
large
Plasma amount compared to amount of blood in body)
:closed_umbrella:
Rh
blood group
Protein on RBC’s surface
2nd in importance other than ABO
Consists of Ag D, C, c, E, e
Got Ag
D
or not?
Yes ➯ Rh positive (Rh+) ➯ can’t produce anti-D ➯ can receive Rh
+ or -
blood
No ➯ Rh negative (Rh-) ➯ can produce anti-D ➯ can only receive Rh
-
blood
Exception in Emergency conditions
— Rh
-
that still doesn’t produce Anti-D
can still
receive Rh
+
(gives only 1 time) ➯ later chance for Ab production 80-90%
If receive Ag D in unnatural Ab production setting ➯ stimulate immune response production ➯ got Ab