Blood transfusion – BDS Study

1 Blood Transfusion

Blood transfusion is a process during which blood or blood components are transfused from one person (donor) into the bloodstream of another person (recipient).

Transfusion may be done as a lifesaving procedure to replace blood cells or blood products lost through bleeding.

2 Indications of Blood Transfusion

Indications: Indications means the symptoms or condition of a disease that indicate or suggest the necessity of medical treatment.

Conditions Requiring Blood Transfusion

Anemia
Hemorrhage
Trauma
Burns
Surgery

3 Types of Blood Transfusion

Blood transfusion is of four types:

1. Whole Blood Transfusion

Preferred during:

Hemorrhage in severe trauma
Surgery
Bleeding disorders, etc.

2. Red Blood Cell Transfusion

Commonly used in anemic patients.

3. Platelet Transfusion

Beneficial for patients suffering from:

Thrombocytopenia
Dysfunction of platelets

Used for patients with bone marrow failure as prophylactic transfusion.

Also used for patients with:

Leukemia
Other types of cancer

Used when low platelet count is caused by side effects of chemotherapy.

4. Plasma Transfusion

Given to patients affected by:

Burns
Shock
Severe infections
Liver failure

4 Precautions

Certain precautions must be followed before and during transfusion of blood to a patient.

Precautions Followed Before Transfusion

1. Donor

Donor must be healthy and without diseases such as:

Sexually transmitted diseases like syphilis
Diseases caused by viruses like hepatitis, AIDS, etc.

2. Blood Compatibility

Only compatible blood must be transfused.
Rh compatibility must also be confirmed.

3. Matching

Both matching and crossmatching must be done.

Precautions Followed During Transfusion

1. Sterile apparatus

Apparatus for transfusion must be sterile.

2. Temperature

Temperature of blood to be transfused must be the same as body temperature.

3. Slow transfusion

Transfusion of blood must be slow.

Sudden rapid infusion of blood into the body increases the load on the heart, resulting in many complications.

5 Hazards of Blood Transfusion

A. Reactions Due to Mismatched Blood Transfusion

Transfusion reactions

Transfusion reactions due to:

ABO incompatibility
Rh incompatibility

B. Reactions Due to Massive Blood Transfusion

Massive transfusion: Transfusion of blood equivalent to or more than the patient’s own blood volume.

It Leads To:

1. Circulatory shock

Particularly in patients suffering from:

Chronic anemia
Cardiac diseases
Renal diseases

2. Hyperkalemia

Due to increased potassium concentration in stored blood.

3. Hypocalcemia

Leading to tetany due to massive transfusion of citrated blood.

4. Hemosiderosis

Increased deposition of iron in the form of hemosiderin in organs such as:

Endocrine glands
Heart
Liver

Occurs due to iron overload after repeated transfusions.

C. Reactions Due to Faulty Techniques During Blood Transfusion

1. Thrombophlebitis

Inflammation of vein associated with formation of thrombus.

2. Air Embolism

Obstruction of blood vessel due to entrance of air into the bloodstream.

D. Transmission of Infections

Blood transfusion without precaution leads to transmission of bloodborne infections such as:

HIV
Hepatitis
Glandular fever or infectious mononucleosis
- Acute infectious disease caused by Epstein-Barr virus.
- Characterized by:
  - Fever
  - Swollen lymph nodes
  - Sore throat
  - Abnormal lymphocytes
Herpes
- Viral disease with eruption of small blister-like vesicles on skin or membranes.
Bacterial infections

6 Blood Substitutes

Blood substitutes are substances infused as a replacement for blood or to expand blood volume.

Commonly Used Blood Substitutes

Human plasma
0.9% sodium chloride solution (saline)
5% glucose
Colloids like:
- Gum acacia
- Isinglass
- Albumin
- Animal gelatin

7 Exchange Transfusion

Exchange transfusion is a procedure which involves:

Removal of patient’s blood completely
Replacement with fresh blood or plasma of the donor

It is otherwise known as replacement transfusion.

Important: It is an important lifesaving procedure carried out in conditions such as:

Severe jaundice
Sickle cell anemia
Erythroblastosis fetalis
Etc.

8 Procedure for Exchange Transfusion

Procedure for exchange transfusion involves both:

Removal
Replacement

Of affected blood in stages.

Exchange transfusion is carried out in short cycles of few minutes duration.

1

Removal of blood

Affected person’s blood is slowly drawn out in small quantities of 5–20 mL.

Quantity depends upon:

Age and size of person
Severity of the condition

2

Replacement

Equal quantity of fresh, pre-warmed blood or plasma is infused through an intravenous catheter.

This is carried out for few minutes.

3

Catheter retained

Catheter is left in place.

Transfusion is repeated within few hours.

4

Completion

Procedure is continued till the whole predetermined volume of blood is exchanged.

9 Indications of Exchange Transfusion

Hemolytic disease of newborn (erythroblastosis fetalis)
Severe sickle cell anemia
Severe polycythemia
- Replacement with saline, plasma or albumin
Toxicity of certain drugs
Severe jaundice in newborn babies which does not respond to ultraviolet light therapy.
- Normally, neonatal jaundice is treated by exposure to ultraviolet rays.
- Ultraviolet rays break down the bilirubin, which is excreted by the liver.

10 Autologous Blood Transfusion

Autologous blood transfusion is the collection and reinfusion of patient’s own blood.

It is also called blood donation.

Other Terms

Allogeneic blood transfusion

Conventional transfusion of blood that is collected from persons other than the patient.

Heterologous blood transfusion

Conventional transfusion of blood that is collected from persons other than the patient.

Use

Autologous blood transfusion is used for planned surgical procedures.
Patient’s blood is withdrawn in advance and stored.
Later, it is infused during surgery if necessary.

Advantages Mentioned in the Source

Prevents transmission of viruses such as:
- HIV
- Hepatitis B
Eliminates transfusion reactions.