Blood Transfusion

Define transfusion & Infusion. (Viva)

Definition (Transfusion): Introduction of blood or any

Blood products directly into the blood.

** Definition (Infusion): Therapeutic introduction of any fluid, other than blood directly into the circulation is known as infusion.

Q: 02=what are the blood components? (Viva)

Ans=Types of blood components:

a.      Whole blood.

b.      Packed red cells.

c.       Platelet rich plasma.

d.      Platelet concentrate(Cryoprecipitate)

e.       Plasma

f.       4.5% Human albumin

g.                  Fresh frozen plasma.

h.      Factors 8&9 concentrate.

i.        Fibrinogen

what are the indication, contraindication &Complication of

blood transfusion? Give the management of mismatched blood Transfusion. (Nov-10)(July-11)

Ans=Indication of blood transfusion:

  (1)For the replacement of acute sever blood loss,

 (A)Traumatic:

·         Crush injury, major fracture.    

·         Rupture spleen, Liver, great vessels.

(B)Pathological:

·         Bleeding peptic ulcer.

·         Rupture ectopic pregnancy.

(2)For the correction of peri-operative anemia,

Major operation:

·         Gastrectomy, thyroid surgery.

·         Heart, Lung surgery.

·         Liver surgery etc.

(3)Sever burn, gross infection, and septicemia.

(4)Sever anaemia – (Hook warm) packed cells.

(5)Certain blood disorders:

·         Hemophilia.

·         Leukemia.

·         a plastic anemia.

(6) During chemotherapy.

(7) Certain liver disease.

v Contraindication of blood transfusion:

(1) Advanced bilateral renal disease.

(2)Sever heart disease.

(3) Hypertension.

(4) Established heart failure.

 (5) Coronary artery thrombosis.

(6) Pulmonary odema, embolism.

(7) Polycythaemia.

v Complication of blood transfusion:

(1)   Febrile reactions.

·         Pyrogen and minor bacterial contamination.

·         Immunological reaction to WBC, Platelet.

·         Unexplained.

     (2)Allergic reactions:

               #Plasma antigen from donor occasionally cause itch, headache.    (3)Hemolytic reactions :( 50 ml blood can cause)

·          Acute intravascular haemolysis.

·         Pain at infusion site.

·         Loin pain.

·          Hypotension, chest pain, renal failure.

(4)Physical complications:

·         Circulatory embolism.

·         Air embolism.

·         Pulmonary embolism.

(5)Metabolic complications:

·         Hyperkalaemia.

(6)Transmission of diseases,

·         Hepatitis B.

·         AIDS.

·         Syphilis.

·         Malaria etc.

(7)Hemorrhagic reactions:

·         After massive transfusion of stored blood.

·         DIC.

(8)Haemosiderosis=after repeated transfusion.

**Complication of massive blood transfusion:

(1) Hypothermia.

(2) Multiple micro emboli.

(3) Acid base disturbance, metabolic acidosis.

(4) Jaundice.

(5) Hyperkalamia.

v Management of blood transfusion:

·         Immediately stop the transfusion.

(1)    Inj.Hydrocortisone 100 mg.

(2)    Inj.Chlorpheniramine 10 mg.

(3)    Keep the I/V line open with 0.9% NaCL.

(4)    Heparinization.

(5)    Vasopressor drugs.

(6)    O2 inhalation.

(7)    Diuretics.

(8)    Mannitol(Increase BP & Urine output)

(9)    Bicarbonate with Ringer”s lactate

(10)     Dialysis, if required-peritoneal and haemodialysis

(11)     Check identity against name on unit

(12)        Send the unit of blood, sample of fresh blood & urine

(For haemoglobinuria) to the lab.

 what are the clinical features of blood transfusion? (Viva)

Ans=Clinical features:

A)   Immediate:

1. Chill.

2. Rigor.

3. Fever spike up to 40’ c

4. Features of shock

5. Tachycardia

6. Lion pain

7. Constriction pain of chest and back

8. Hypotension

9. Occipital headache

10. Vomiting

11. Muscle Cramp

12. DIC

B)   Delayed:

1. Jaundice

2. Haemoglobinuria.