BLOOD TRANSFUSION, PRODUCTS, COMPLICATIONS AND GUIDELINES

BLOOD TRANSFUSION, PRODUCTS, COMPLICATIONS AND GUIDELINES

INTRODUCTION / DEFINITION

Blood transfusion is the procedure in which blood is given to a patient intravenously. It replaces lost blood due to surgery, injury, anaemia, or when the body cannot produce blood properly due to illness.

CONSTITUENTS OF BLOOD

Plasma: 55% of blood volume; contains electrolytes, nutrients, vitamins, hormones, proteins, and clotting factors.
Red Blood Cells (Erythrocytes): Carry oxygen; produced in bone marrow; contain hemoglobin.
White Blood Cells (Leukocytes): Destroy pathogens; part of the immune system.
Platelets (Thrombocytes): Aid clot formation with coagulation factors.

TYPES OF TRANSFUSION

Whole blood transfusion
Component therapy (e.g., RBC, platelets, FFP, cryoprecipitate)

INDICATIONS FOR TRANSFUSION

Anaemia (acute or chronic)
Acute blood loss
Sickle cell anaemia
Overwhelming infection
Surgical intervention (pre, intra, post)
Coagulation dysfunction (e.g., DIC)
Thalassemia, leukemia, lymphoma
Hypovolemia, hemolysis, critical illness

DETERMINANTS OF BLOOD LOSS

Clinical symptoms: fatigue, dizziness, SOB
Clinical signs: pallor, capillary refill
Surgical estimation: suctioned blood volume, soaked gauze

INVESTIGATIONS

Hemoglobin: Males (13–14 g/dL), Females (12–13 g/dL)
Full blood count
Packed cell volume

TRANSFUSION TYPES

Autologous: Donor and recipient are same individual.
Homologous: Between individuals of same species.
Heterologous: From different species.

ACUTE HEMOLYTIC TRANSFUSION REACTION

Occurs minutes to hours post-transfusion of incompatible blood.
To prevent: match ABO/Rh groups; label units correctly.

Symptoms:

Fever, chills, rash, flushing
Renal failure, low/high BP, nausea
Back/chest pain, tachycardia
Hemoglobinuria, circulatory collapse

Management:

Stop transfusion, call for help
Assess vitals and symptoms
Re-crosscheck patient and blood unit identity
Send blood and new sample to lab
Treat with IV fluids, antipyretics, hydrocortisone, antihistamines

COMPLICATIONS

1. Immunological

RBC: Acute/delayed hemolytic reactions
WBC: Febrile reactions, TRALI, TA-GVHD
Platelets: Post-transfusion purpura
Others: Urticaria, anaphylaxis

2. Non-Immunological

Vasoactive reactions (hypotension, nausea)
Pyrogens (fever from contamination)
Cold blood (risk of cardiac arrest)
Citrate toxicity (hypotension, tremor)
Potassium toxicity, air/microembolism
Iron overload: treated with Desferrioxamine

3. Infectious

Bacteria: Gram ±
Protozoa: Chagas, Malaria, Toxoplasmosis, Leishmaniasis
Viruses: Hep B/C, HIV, CMV

GUIDELINES FOR BLOOD TRANSFUSION

Principles:

Right blood, right patient, right time, right place.

Key Guidelines (BCSH 2019):

Positive Identification: Confirm patient’s full identity (name, DOB, ID number).
Informed Consent: Explain benefits, risks, and alternatives.
Documentation: Record reason, consent, and clinical data.
Prescription: Must include patient info, component type, volume, rate, date.
Request: Include identifiers, diagnosis, volume needed, transfusion location.
Blood Sampling: Proper labelling by trained personnel only.
Collection/Delivery: Trained staff must verify and deliver promptly.
Administration: Final ID check at bedside; transfusion via 170–200μm filter; complete within 4 hours.
Monitoring: Check vitals before, 15 min after start, and after completion. Watch for reactions.
Post-Transfusion: Document everything; observe for late symptoms.

Let me know if you also want a PDF version, HTML version, or a conversion into Google Docs format.