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Blood Component Therapy

Blood Component Therapy. Salwa I Hindawi MSc FRCPath CTM Director of Blood Transfusion Services. Mohamad H Qari,MD,RCPA Associate Professor and Chairman/Hematology Dept. RBC Agglutination. ABO type. Pt Cells Pt Serum vs vs

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Blood Component Therapy

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  1. Blood Component Therapy Salwa I Hindawi MSc FRCPath CTM Director of Blood Transfusion Services Mohamad H Qari,MD,RCPA Associate Professor and Chairman/Hematology Dept. 4th year medical students

  2. RBC Agglutination 4th year medical students

  3. ABO type Pt Cells Pt Serum vs vs anti-A anti-B Acells Bcells • A + 0 0 + 40% • B 0 + + 0 11% • AB + + 0 0 4% • 0 0 0 + + 45% 4th year medical students

  4. BLOOD COMPONENT THERAPY It is the transfusion of specific blood components required by the patient. Principles • Use blood products only when it is essential. • Replace only the deficient component, if possible. • Identify the cause and nature of the deficiency and if possible, treat it. 4th year medical students

  5. Platelets rich plasma Platelets concentrate 2nd centrifugation Whole blood Whole blood Whole blood 1stcentrifugation FFP for clinical use Red Cell concentrate FFP for fractionation Fresh plasma Optimal additive solution Cryoprecipitate Red cells in OAS 4th year medical students

  6. Blood COMPONENTS AVAILABLE FROM THE BLOOD BANK • Whole blood • Packed RBCs • Platelets • Single donor platelets (Apheresis) • Fresh Frozen Plasma (FFP) • Cryoprecipitate 4th year medical students

  7. Indication for Red Blood Cells Transfusion • Red blood cells are component of choice to maintain an adequate supply of oxygen to meet tissue demands.One unit increase the haemoglobin level by 1g/dL in a 70kg recipient. 4th year medical students

  8. Indication for Transfusion of Whole Blood • Fresh whole blood<5 days old is often used for exchange transfusion in newborns. • Stored whole blood can be used in actively bleeding patients who have lost > 30-40% of their blood volume. 4th year medical students

  9. Indication for red blood cells Transfusion • Symptomatic anaemia • Acute blood loss>30-40% of blood volume. • Pre-operative Hb< 8g/dl and operative procedure associated with major blood loss. • Evidence of inadequate oxygen delivery. 4th year medical students

  10. Administration and Dose • Red blood cells transfusion has to be ABO & Rh specific. • This component must be administered through a suitable transfusion set • Dose of 4ml/kg raises venous Hb by about 1g/dl. 4th year medical students

  11. Specifications • Whole blood volume 450mls+63mls of CPD-A1 anticoagulant. • Packed RBCs volume 250mls±50mls. • Hct=0.55-0.75. • Anticoagulant CPD-A1 store at 4c°±2c° for 35 days. • SAG-M for 42 days. 4th year medical students

  12. Indication for Platelet Transfusion • Decrease platelet production (Bone marrow failure) • Therapeutic:for patient who are bleeding associated with BMF caused by either disease, therapy or irradiation. • Prophylactic: >10x 109/L to decrease morbidity in patients with thrombocytopenia due to B.M.F. 4th year medical students

  13. Cont, Platelet Transfusion • In acute D.I.C (Disseminated intravasculr coagulation). • In neonatal alloimmune thrombocytopenia (NAIT) from donor known to be negative for the appropriate HPA or mother platelet. • Platelet function disorders or thrombocytopenia <50x 109/L going for invasive procedure, for operation in critical sites such as the brain or eyes the platelet count should be raised to 100x109/L. • In massive blood transfusion, the platelet count to be maintained above 50x109 /L. 4th year medical students

  14. Administration of Platelet Concentrate: • ABO compatible platelet are preferred but not necessary. • Platelet concentrate should be transfused as soon as possible after reaching the ward with standard blood transfusion sets with 170 mm filters. • The transfusion should normally be completed within 30 minutes. • Observation during platelet transfusion should include pulse& temperature before& after transfusion. 4th year medical students

  15. Indications For The Use Of FFP Definite indication: • Replacement of single factor deficiencies • Immediate reversal of warfarin effect • Vitamin K deficiency • Acute disseminated intravascular coagulation • Thrombotic thrombocytopenic purpura • Inherited deficiencies of inhibitors of coagulation:at, protein S, protein C. • CI esterase inhibitor deficiency 4th year medical students

  16. Conditional uses of FFP • FFP is only indicated in the presence of bleeding and disturbed coagulation. • Massive transfusion • Liver disease • Cardiopulmonary bypass surgery • Special Paediatric indications: sever sepsis, DIC. 4th year medical students

  17. Administration of FFP • 1unit of FFP= APPROXIMATELY 200 ML • Dose = 12-15 ml/kg • Should be administered within 2 hours of thawing. • PT & PTT used for monitoring in addition to the clinical assessment. • ABO compatible FFP should be used. Compatibility testing is not required. Group O should only be given to group O recipient. Group A or B FFP can be given to group O recipient. Group AB FFP should be reserved for group AB recipients and for emergencies. 4th year medical students

  18. Indications for The Use Of Cryoprecipitate1-congenital or Acquired Fibrinogen Deficiency.2-Haemophilia A, vonWillebrand’s Disease.3-factor X111 Deficiency4-disseminated intravascular coagulopathy(DIC). 4th year medical students

  19. Administration of Cryoprecipitate • 1 unit of cryo= approximately 10-20ml • Adult dose equivalent to 10 units of cryo • For factor replacement the dose can be calculated according to the volume of the factor in the concentrate. • Fibrinogen 150-300mg/pack • Von Willebrand factor 80-120u/pack • Factor V111c 80-120u/pack • Factor X111 20-30% of factor X111 present in the FFP. • Should be ABO compatible to avoid risk of haemolysis caused by donor antiA or antiB. • Should be administered within 4 hours of thawing. 4th year medical students

  20. Platelet, ApheresisAn adult dose of Platelets prepared from anticoagulated blood which is separated into components by apheresis machine with retention of the platelets and a portion of the plasma.The remaining elements may be returned to the donor 4th year medical students

  21. Specification Volume 200 – 800 mlsPlatelet count > 240 x 109 / unitLeucocyte count < 5 x 108 / unit PH at end of shelf life 6.4-7.4Availability:On request.Shelf life storage: 5 days at 22 ± 2°c gently agitated 4th year medical students

  22. Thank You 4th year medical students

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