Blood Transfusion

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

ghareib sheikh on May 04, 2012 Says :

well done

khondoker on Aug 09, 2011 Says :

thank u everybody

DAVID on Aug 09, 2011 Says :

i am thrilled by this piece of work.

Sayeed on Aug 24, 2009 Says :

thanks a lot

ram on Aug 24, 2009 Says :

its good

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

4 Favorites

saramazhari87, favourited this 1 Years ago.

kiran1985, favourited this 1 Years ago.

faria fatima, favourited this 3 Years ago.

michelgreiss, favourited this 3 Years ago.

First Prev [1] Next Last

Notes

Hide Notes

Slide 1 :

Overview of Blood Transfusion for Management of Complicated Cases Prof. Dr. Husne Ara Begum Transfusion Medicine Dept. Dhaka Medical College

Slide 2 :

Proper selection of donor Screening of donor Compatibility tasting Rational use of blood component therapy For better Management we should strictly maintained

Slide 3 :

Restoration of blood volume Enhance the O2 carrying capacity of blood Maintain Homeostasis Platelet Coagulation Factors Fresh blood FFP or Appropriate component Objectives of B.T & Component therapy

Slide 4 :

20% loss – no need 20%-30% loss - plasma substitution >30% - Blood transfusion Blood Transfusion

Slide 5 :

Before transfusion we must determine me WHAT for any procedure WHAT - Whether required - How much required - Actual component required - Time of duration of transfusion

Slide 6 :

A. Immediate reactions Febrile reaction Allergic reactions Hemolytic transfusion reaction Circulatory over load Air embolism Potassium toxicity Citrate toxicity Reaction due to infected blood Complication of Blood Transfusion

Slide 7 :

Thrombophlebitis TTDs / TTI AIDS (HIV) Hepatitis (HBV, HCV) Syphilis (Treponema pallidum / Spirochetes) Malaria (M.P), C.M.V & other Immunological sensitization or alloimmunization Transfusion haemosiderosis Post transfusion purpura HTR Graft-versus-host disease (GVHD) Complication of massive transfusion Delayed transfusion reactions

Slide 8 :

Incompatibility between donors and recepient 99% caused of human error preventable by Adequate knowledge of blood groups Careful attention to all details of the techniques Blood group incompatible Outdated and infected blood Haemolysed blood Incorrect anticoagulant HTR

Slide 9 :

4-5 units of FFP- deterioration of normal hemostasis There after 4 units of FFP for every 06 units of red cells Cryoprecipitate hypofibrinogenemia Calcium gluconate – If needed Initial FFP therapy

Slide 10 :

Symptoms Severe aching in the transfused vein Pain in lumber region & back Dyspnoea Nausea Vomiting Flushing of the face Chill & rigors ? Temperature Anxiety Restless Feeling of constriction of chest HTR

Slide 11 :

Signs ? Temp. Tachycardia ? B.P Unexplained bleeding (DIC) Shock - ? urinary output ? Anuria ? Death HTR

Slide 12 :

Under anesthesia and sedation Symptomless Signs Bleeding from wound / needle sites Persistent hypotension Tachycardia HTR

Slide 13 :

Investigations Stop transfusion 10 ml blood sample in test tube 2 ml in oxalated tube Urine sample- collected for 2-3 days measure & examine Blood for GM staining & C/S Exclude clinical error HTR

Slide 14 :

Lab investigation Re-grouping the donor and recipient Re cross match Examine Post transfusion sample for agglutinated RBC Coomb’s test Screen donor sample HTR

Slide 15 :

Biochemical Test Post transfusion sample for free Hb & bilirubin and compare with pre transfusion sample Urine for free Hb & RBC casts Schumm’s test for met Hb HTR

Slide 16 :

Hematological test Blood for Hb, TC of RBC PBF with post transfusion sample for morphology of RBC HTR

Slide 17 :

Bacteriological test From donor blood residue for gram staining & C/S HTR Diagnosed after recheck - Visual inspection of serum & urine - Lab, Investigation , follow up

Slide 18 :

Management HTR AIM - Fluid and Electrolyte Balance - Nutrition Stop transfusion - keep IV channel open with saline & hydrocortisone Maintain input output chart Inj. Frusemide Inj. Heparin FFP/compatible fresh whole blood Infusion mannitol If no diuresis – peritoneal dialysis

Slide 19 :

50% glucose solution 500 ml/day Input output chart Infection antibiotic Anemia – Packed RBC High CHO & low protein diet If no satisfactory response - renal unit Period of Oliguria 7-21 days

Slide 20 :

Period of diuresis Fluid - 1L/day + urinary loss on previous day - High CHO & Low protein diet

Slide 21 :

Pathophysiology of DIC Massive issue injury Sepsis Extensive endothelial injury Release of tissue factor Platelet aggregation Bleeding Widespread microvascular thrombi Activation of plasmin Microangiopathic hemolytic anemia Microvascular occlution Ischemic tissue injury Fibrinolysis Proteolysis of clotting factor FDP Inhibition of thrombin, platelet aggregation, fibrin polymerization

Slide 22 :

Clinical features Severe acute DIC manifest with mucosal oozing, gastrointestinal blood loss, bleeding from surgical incisions or sites of venous access. Deposition of thrombi in the microcirculation can lead to multiple organ failure. Renal failure to hypovolemia & fibrin deposition in the renal vasculature Usually by gm (–ve) organism Occasionally by gm (+ve) organism Peripheral vasodilatation causes hypotension? shock ? death

Slide 23 :

Management of DIC Principles are a. elimination of precipitating factor – if possible b. replacement of coagulation factors platelet fresh whole blood FFP fibrinogen c. inhibition of the clotting process with heparin or other agents

Slide 24 :

Monitor Prothrombin time (PT), Thrombin time (TT) Platelet count Fibrinogen level APTT FDP or SFM (Soluble fibrin monomers)

Slide 25 :

It is defined as transfusion / infusion of whole blood equal to or exceeding the persons blood volume within 24 hrs period. Massive transfusion

Slide 26 :

Indications Medical emergencies Major surgery Exchanged transfusion

Slide 27 :

Problem of massive blood transfusion Physical Hypothermia Chemical Hypocalcaemia Acidosis Hypokalemia associated with metabolic alcalosis

Slide 28 :

Problem of massive blood transfusion…….. Physiological O2 dissociation curve – shift to the left Depletion of labile coagulation factors Dilutional thrombocytopenia

Slide 29 :

Objective of massive blood loss To restore & maintain adequate blood volume To maintain sufficient O2 carrying capacity To secure haemostasis

Slide 30 :

Following haematological parameters should be performed & correctly measure taken

Slide 31 :

Thank you

POST LUMBAR PUNCTURE...

Chromatographic anal...

Blood and Marrow Tra...

Correlation between ...

Alternativas a la tr...

Transfusion de deriv...

Free Powerpoint Templates

	sayeed_opso 4 Years ago.



19508 Views, 6 favourite
Overview of Blood Transfusion for Management of Complicated Cases- Slides
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel