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Blood Components Dosage And Their Administration.

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Presentation on theme: "Blood Components Dosage And Their Administration."— Presentation transcript:

1 Blood Components Dosage And Their Administration

2 Effective blood transfusion therapy depends on availability of different blood components Components used separately or in combination can meet most patients transfusion needs and keep the risk of transfusion to minimum

3 Separation of blood components are desirable because 1. Separation of blood components allows optimal survival for each component 2. Allows transfusing specific blood components according to the need of the patient 3. Allows use of unnecessary component which may be contraindicated in a patient

4 4. Several patients can be treated from one unit of donated blood 5. Use of blood components supplements blood supply and adds to the blood inventory

5 Whole Blood Processed within 8 hours ) Packed red blood cells Fresh frozen plasma Platelets

6 Component preparation Principle - Differential centrifugation Principle - Differential centrifugation Red cells Red cells Packed cells Packed cells Red cells + additive Red cells + additive Plasma Plasma Bank plasma Bank plasma Fresh frozen Fresh frozen Cryo supernate Cryo supernate Platelets Platelets Platelet rich concentrate Platelet rich concentrate Platelet rich plasma Platelet rich plasma Cryoprecipitate Cryoprecipitate Plasma + Platelets Buffy RBC Whole blood

7 DEFINITIONS BLOOD PRODUCT = Any therapeutic substance prepared from human blood WHOLE BLOOD = Unseparated blood collected into an approved container containing an anticoagulant preservative solution BLOOD COMPONENT = 1. A constituent of blood, separated from whole blood such as Red cell concentrate Red cell concentrate Plasma Plasma Platelet concentrates Platelet concentrates 2. Plasma or platelets collected by apheresis 3. Cryoprecipitate prepared from fresh frozen plasma

8 Blood Components THE PRBC THE PRBC Storage Storage - 2 – 6 O C - 2 – 6 O C Unit of issue Unit of issue - 1 donation ( unit or pack ) - 1 donation ( unit or pack ) Administration Administration - ABO & Rh compatible - ABO & Rh compatible - Never add medication to a unit - Never add medication to a unit - Complete transfusion within 4 hrs of commencement - Complete transfusion within 4 hrs of commencement 1MemberMember

9 Blood Components 2. Red cell concentrate ( packed red blood cells )- whole blood without plasma. Hct %, Hb approximately 20 g /100 ml

10 Indications Trauma - Acute blood loss with > 20% loss of blood volume Surgery - Trigger – 10gm% - 8gm% Rate of development of anemia, General condition and type of surger Radiotherapy

11 Dosage & Administration Dosage - 1 unit/10 kg body wt Adult dose is 4-8 units Administration - Preferably ABO & Rh group specific but not essential Other groups can be used

12 PLATELETS Platelet units can be either Platelet units can be either Random donor units Random donor units Apheresis units Apheresis units 1 random donor unit contains 55 x10 9 platelets 1 random donor unit contains 55 x10 9 platelets 1 apheresis unit contains 240x apheresis unit contains 240x10 9

13 Indications  Production - Aplasia / Neoplasia  Usage - TTP(thrombotic thrombocytopenic purpura), DIC(disseminated intravascular coagulation)  Destruction – immune thrombocytopenic purpura. Sequestration – Hyper- splenism

14 Guidelines for Platelet Tx. Mild - 50,000-1,00,000/µl Tx - usually not required Moderate - 20,000-50,000/µl Tx-if symptomatic or has to undergo surgery/trauma Severe - < 20,000/µl Risk of bleeding - high Prophylactic Tx

15 Indications for platelet transfusion BLEEDING due to thrombocytopaenia BLEEDING due to thrombocytopaenia Due to platelet dysfunction Due to platelet dysfunction Prevention of spontaneous bleeding with counts < 20,000 Prevention of spontaneous bleeding with counts < 20,000

16 IMPORTANT PRECAUTIONS IMPORTANT PRECAUTIONS Stored at Degree celcius. Stored at Degree celcius. Constantly agitated Constantly agitated Only last for 5 days Only last for 5 days Infused in 30 mins Infused in 30 mins

17 Fresh Frozen plasma Fresh frozen plasma – labile & nonlabile clotting factors, albumin and immunoglobulin. Factor VIII ( 8 ) level at least 70 % of normal fresh plasma level Fresh frozen plasma – labile & nonlabile clotting factors, albumin and immunoglobulin. Factor VIII ( 8 ) level at least 70 % of normal fresh plasma level Storage Storage - 20 C for 1 yr, - 65 C for 7 yrs C for 1 yr, - 65 C for 7 yrs. - Before use thawed at 37 o C

18 Fresh frozen plasma Fresh frozen plasmaIndications - Replacement of multiple coagulation factor deficiencies eg Liver disease Liver disease Anticoagulant overdose Anticoagulant overdose Depletion of coagulation factors in pts receiving large volume transfusions Depletion of coagulation factors in pts receiving large volume transfusions - DIC (disseminated intravascular coagulation)

19 FRESH FROZEN PLASMA Indication  Clinically significant deficiency of Factors II, V, X, XI  Replacement of multiple coagulation factor deficiencies :- factor deficiencies :- liver disease, warfarin treatment, liver disease, warfarin treatment, dilutional and consumption coagulopathy dilutional and consumption coagulopathyContraindication Volume expansion Volume expansion Immunoglobulin replacement Immunoglobulin replacement Nutritional support Nutritional support Wound healing Wound healing 19

20 FRESH FROZEN PLASMA Precaution Acute allergic reaction are common Acute allergic reaction are common Anaphylactic reaction may occur Anaphylactic reaction may occur Hypovolemia alone is not an indication for Hypovolemia alone is not an indication for use use Dosage - Initial dose of ml / kg Administration Must be ABO compatible, Rh not required Must be ABO compatible, Rh not required Infuse as soon as possible after thawing Infuse as soon as possible after thawing ( within 6 hrs ) ( within 6 hrs ) using standard blood administration set using standard blood administration set 30/11/49 MD

21 FFP Fresh Frozen Plasma Fresh Frozen Plasma Plasma collected from single donor units or by apheresis Plasma collected from single donor units or by apheresis Frozen within 8 hours of collection Frozen within 8 hours of collection -40 o C -40 o C Can last for a year Can last for a year

22 Dosage & Administration for FFP Dosage ml/Kg(Approx 2-3 bags for an adult) Administration - Thawed at +37 o C before transfusion ABO compatible Group AB plasma can be used for all patient

23 Do`s and Dont`s In Blood and Blood Components

24 24 DO`S Complete the blood request form Order blood in advance, if possible Provide clear information on blood products being requested, number of units requested, reason for transfusion, urgency

25 Risk Benefit Analysis benefit > risk risk > benefit Hb gm/dl why not transfuse why transfuse individual patient factors decide transfusion trigger

26 26 Blood/ Start infusion Complete infusion blood product Whole blood/within 30 min. of within 4 hour red cells removing pack (less in high from ambient temperature) refrigerator Platelet immediatelywithin 20 min concentrates FFP within 30 min within 20 min Time Limits for Infusion

27 RECORDING OF TRANSFUSION 27 Consent from patient and/or relatives Reason for transfusion Signature of the prescribing clinician Pre-transfusion checks of : patient’s identity, blood pack, compatibility label signature of the person performing the check Transfusion type and volume of component, donation number, blood group, time at which transfusion commenced, signature of person administering the transfusion Any transfusion reaction Return the transfusion slip to the blood bank


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