Lecture on Blood component therapy
- 1. Lecture onLecture on (we care change and(we care change and Challenge)Challenge) BLOOD COMPONENTSBLOOD COMPONENTS THERAPYTHERAPY Dr. Md. Hafizur RahmanDr. Md. Hafizur Rahman MBBS,MTM(BSMMU)MBBS,MTM(BSMMU) Assistant ProfessorAssistant Professor Dept. OF Transfusion MedicineDept. OF Transfusion Medicine Enam Medical College & HospitalEnam Medical College & Hospital
- 2. What are the Blood ComponentsWhat are the Blood Components?? These are the productsThese are the products separated from a single unit ofseparated from a single unit of whole blood.whole blood. Plasma derivatives:Plasma derivatives: These are the products separated from a largeThese are the products separated from a large volume of pooled Plasma by a process calledvolume of pooled Plasma by a process called fractionation. These are not included under Bloodfractionation. These are not included under Blood Components.Components.
- 4. 30/11/49 MD-3-49 4 Types of Blood ComponentsTypes of Blood Components A) Whole Blood Fresh Blood B) Red Blood cells 1. Packed Red Cells 2. Leukocyte Reduced Red Blood Cells 3. Irradiated Red cells 4. Frozen Red cells 5. Washed Red cells C) Platelet Concentrate D) Leucocyte Concentrate E) Plasma 1) Fresh Frozen Plasma 2) Cryoprecipitate • 3) Stored Plasma
- 6. What are the Principles of BloodWhat are the Principles of Blood Transfusion?Transfusion? We transfuse Blood for the following purposes: 1. Replacement of red cells to increase the oxygen carrying capacity to prevent tissue hypoxia. 2.To correct insufficient coagulation factors when there is abnormality in blood coagulation. 3. Blood is also used for restoration of blood volume when hypovolaemia threatens the integrity of the circulatory system.
- 7. PRINCIPLE OF BLOOD COMPONETS THERAPYPRINCIPLE OF BLOOD COMPONETS THERAPY It is now a days agreed that whole bloodIt is now a days agreed that whole blood is no longer the treatment of choice where thereis no longer the treatment of choice where there is known deficiency of single component andis known deficiency of single component and where the concentrate of that elements arewhere the concentrate of that elements are more effective.more effective. So the transfusion of whole blood isSo the transfusion of whole blood is wasteful when only one component is needed.wasteful when only one component is needed. There may be less hazards of single componentThere may be less hazards of single component transfusion than the whole Blood.transfusion than the whole Blood. So it is wise to avoid unnecessarySo it is wise to avoid unnecessary transfusion of whole blood.transfusion of whole blood.
- 8. ADVANTAGES OF BLOOD COMPONENTSADVANTAGES OF BLOOD COMPONENTS THERAPYTHERAPY 1. It is a specific therapy and more1. It is a specific therapy and more effective therapy.effective therapy. 2. More than one patient can get2. More than one patient can get benefit from a singlebenefit from a single donation.donation. 3. It can reduce the3. It can reduce the unwanted hazards ofunwanted hazards of whole blood transfusion.whole blood transfusion. 4. In some cases it can4. In some cases it can avoid circulatoryavoid circulatory overload.overload.
- 14. BLOOD COMPONENTSBLOOD COMPONENTS • WHOLE BLOOD:WHOLE BLOOD: It is a donor blood with anticoagulantIt is a donor blood with anticoagulant and preservative solution.and preservative solution. Components of WHOLE BLOOD: 1. Whole Blood- Itself is a component of Blood 2. Fresh Blood Whole Blood: *450 ml of blood ( 10% less or more) *63 ml of anticoagulant & preservative solution. *Hct = 36-44% *No components have been removed. *Store at 2-60 C
- 15. WHOLE BLOODWHOLE BLOOD • SHELF LIFE: (In the following anticoagulant & preservative solution): • ACD solution = 21 days (3 wks) • CPD = 28 days (4 wks) • CPDA-1= 35 days ( 5 wks)
- 16. Whole BloodWhole Blood AdministrationAdministration - Must be ABO and RhD- Must be ABO and RhD compatible with the recipientcompatible with the recipient - Never add any medication to a unit- Never add any medication to a unit of bloodof blood - Use blood administration set- Use blood administration set -Transfusion should be started-Transfusion should be started within 30 minutes of removal fromwithin 30 minutes of removal from refrigeratorrefrigerator --Infuse within 4 hours of starting ofInfuse within 4 hours of starting of transfusion.transfusion.
- 17. WHOLE BLOODWHOLE BLOOD Drawbacks: – After storage for >24 hours, platelets and WBC are non-functional – Factor V and VIII (labile factors) decrease with storage (drops to 50% within 10-14 days) – After storage Plasma potassium – After storage PH – Chance of Fluid overload ( specially in a patient with pre-existing renal or heart failure where blood volume adjustment may be impaired) – Possibility of Allo-immunization (Antibody formation)
- 18. WHOLE BLOODWHOLE BLOOD INDICATIONS:INDICATIONS: 1. Patients of active bleeding or continuous1. Patients of active bleeding or continuous bleeding & loss of >30% ofbleeding & loss of >30% of blood volume.blood volume. 2. Neonatal exchange transfusion2. Neonatal exchange transfusion (Fresh blood)(Fresh blood) 3.3. Evidence of rapid blood loss without immediate control warrants Whole blood transfusion. CONTRAINDICATION: Risks of volume overloadCONTRAINDICATION: Risks of volume overload in patients within patients with --Severe Chronic anaemiaSevere Chronic anaemia -Incipient cardiac failure-Incipient cardiac failure
- 19. WHOLE BLOODWHOLE BLOOD DOSES:DOSES: 1. One unit of WB increases Hb by 1- 1.5 gm/dl & HCT by1. One unit of WB increases Hb by 1- 1.5 gm/dl & HCT by 3%3% 2. Pediatric: 8ml/kg WB increases Hb by 1-1.5 gm/dl & HCT2. Pediatric: 8ml/kg WB increases Hb by 1-1.5 gm/dl & HCT by 3%by 3% •• This increase may not apparent within 48 to 72 hrsThis increase may not apparent within 48 to 72 hrs after transfusion, because the volume of patient’s bloodafter transfusion, because the volume of patient’s blood will be increased & time is required for normalwill be increased & time is required for normal adjustment of patient’s blood volume after transfusion.adjustment of patient’s blood volume after transfusion.
- 20. FRESH BLOOD (Fresh Whole Blood)FRESH BLOOD (Fresh Whole Blood) 1. Less than 7 days old blood ( some authority says1. Less than 7 days old blood ( some authority says less than 24 hours old, some says < 5 days old)less than 24 hours old, some says < 5 days old) 2. Maintain most of the coagulation factors &2. Maintain most of the coagulation factors & 2,3,DPG enzyme level( responsible for O2,3,DPG enzyme level( responsible for O22 release)release) 3. Less K, citrate & phosphate3. Less K, citrate & phosphate INDICATION OF FRESH BLOOD: •• Neonatal Exchange TransfusionNeonatal Exchange Transfusion •• Infants with Complex Cardiac surgeryInfants with Complex Cardiac surgery •• Patient with hepatic & renal dysfunctionPatient with hepatic & renal dysfunction •• Patient requiring massive transfusionPatient requiring massive transfusion
- 21. RED CELLS COMPONENTS:RED CELLS COMPONENTS: 1. Packed Red cells 2. Leucocyte reduced Red cells 3. Irradiated Red cells 4. Frozen Red cells 5. Washed Red cells PACKED RBC (PRBC): • It is also called RBC concentrate(RCC) • Made by spinning whole blood with the help of centrifuge machine • Expressing off the supernatant Plasma (removing 80% of Plasma). 200 mL (approx.) red blood cell volume. Hct =70% or more Do not provide viable platelets or coagulation factors.
- 22. PACKED RED CELLSPACKED RED CELLS One unit increase Hb by 1-1.5 g/dl or Hct 3%. Must be ABO & Rh compatible Stored at 1-6 o C Shelf-life: 21 days (CPD) 35 days (CPDA-1) 42 days (ADSOL or SAG-M)
- 23. PACKED RED CELLSPACKED RED CELLS Advantages of PRBC’s than WholeAdvantages of PRBC’s than Whole Blood:Blood: 1. Equal oxygen carrying capacity in half the volume.1. Equal oxygen carrying capacity in half the volume. 2. Significant reduction of ABO antibodies facilitates the2. Significant reduction of ABO antibodies facilitates the safe transfusion of “O” group PRBC to non “O” groupsafe transfusion of “O” group PRBC to non “O” group patients.patients. 3. Significant reduction of plasma reduces the risk of3. Significant reduction of plasma reduces the risk of acid level, citrate toxicity & potassium load in patientacid level, citrate toxicity & potassium load in patient with cardiac, renal or liver diseases.with cardiac, renal or liver diseases.
- 24. INDICATIONS OF PRBCINDICATIONS OF PRBC 1. In acute blood loss:1. In acute blood loss: a) If blood loss is –a) If blood loss is – ( In adult)( In adult) (i) >30%(i) >30% (ii) 15%- 30% with pre-existing anaemia or with(ii) 15%- 30% with pre-existing anaemia or with continuous bleedingcontinuous bleeding (iii) 15% with severe cardiac or respiratory(iii) 15% with severe cardiac or respiratory disease.disease. b) Hb. Concentration in Adult-b) Hb. Concentration in Adult- (i) < 7 gm/dl(i) < 7 gm/dl (ii) < 8gm/dl in elderly with cardiovascular or(ii) < 8gm/dl in elderly with cardiovascular or respiratory disease.respiratory disease. 2. Pre-operative2. Pre-operative inin major surgerymajor surgery 3. Peri-operative Transfusion3. Peri-operative Transfusion to compensate surgicalto compensate surgical bleeding.bleeding. 4. Chronic anaemia:4. Chronic anaemia: in Cancer, Leukaemia, Aplasticin Cancer, Leukaemia, Aplastic anaemia, Heamolytic aneamia, Haemorrhagic diseases and inanaemia, Heamolytic aneamia, Haemorrhagic diseases and in other disease causing chronic anaemia.other disease causing chronic anaemia.
- 25. CONTRAINDICATION OF PRBCCONTRAINDICATION OF PRBC • RBC is not indicated –RBC is not indicated – In nutritional anaemia such as Iron deficiency anaemia orIn nutritional anaemia such as Iron deficiency anaemia or pernicious anaemia unless the patient shows signs ofpernicious anaemia unless the patient shows signs of decompensation.decompensation. • DOSE:DOSE: • 1. One unit of PRBC will increase Hb. By 1- 1.5gm/dl &1. One unit of PRBC will increase Hb. By 1- 1.5gm/dl & HCT by 3% in adultHCT by 3% in adult • 2. In pediatric patients: 10 ml/kg will raise Hb. by 2gm/dl &2. In pediatric patients: 10 ml/kg will raise Hb. by 2gm/dl & HCT by 6% .HCT by 6% . – The increase in Hb. & HCT is evident more quickly with RBCThe increase in Hb. & HCT is evident more quickly with RBC transfusion than with Whole Blood because the volumetransfusion than with Whole Blood because the volume adjustment needed less time.adjustment needed less time.
- 26. LEUCO-REDUCED RED CELLSLEUCO-REDUCED RED CELLS • It is the unit of blood from which at least 70% of Leucocytes is removed. Methods of Leucocytes removal: 1. After centrifugation of Whole Blood, buffy coat & plasma removed by plasma extractor. WBC depletion= 80% 2. Washing of PRBC with Normal saline. WBC Depletion= 90% 3. Filtration of WB by Leucocytes filter. WBC Depletion = 90% 4. Glycerol treated RBC by freezing & thawing removes 98% WBC. • 99.9% of white cells filtered out by freezing- thawing-washing technique.
- 27. LEUCO-REDUCEDLEUCO-REDUCED RED CELLSRED CELLS Advantages of leucocytes reduced RBC: – Reduces febrile reactions – Reduces HLA allo-immunization – Effective in reducing CMV, EBV, HTLV & CJD transmission ( Leucocytes may harbour those viruses)
- 28. IRRADIATED RED CELLSIRRADIATED RED CELLS • Gamma-radiation to kill the lymphocytes. • The lack of T-cells prevents graft-vs-host disease. • Use for – Severely immuno-compromised patients – Lymphoma patients – Stem-cell / marrow transplants – Intrauterine transfusion – Neonates undergoing exchange transfusion – Hodgkin’s Disease
- 29. Frozen Red CellsFrozen Red Cells RBCs are glycerolized and frozen < -65 o C for as long as 10 years Good only for 24 hours after thawing De-glycerolization washes away plasma and WBC Advantages: ◦ Blood of rare types can be stored for long periods ◦ Autologous Blood Transfusion to avoid allo-immunisation ◦ Reduces FNHTR, allergic reactions ◦ Safer in massive blood transfusion ◦ Prompt tissue oxygenation
- 30. WASHED RBCWASHED RBC RBC can beRBC can be washed with Normal saline.washed with Normal saline. Indications:Indications: 1. To prevent Febrile Non-haemolytic Transfusion Reaction1. To prevent Febrile Non-haemolytic Transfusion Reaction (FNHTR) due to Leucocytes or platelets antibodies in multi-(FNHTR) due to Leucocytes or platelets antibodies in multi- transfused patients or in woman with multiple pregnancies.transfused patients or in woman with multiple pregnancies. 2. Neonatal or intrauterine transfusion2. Neonatal or intrauterine transfusion
- 31. PLATELET CONCENTRATESPLATELET CONCENTRATES PLATELET CONCENTRATES:PLATELET CONCENTRATES: It should be prepared as early as possible after donation fromIt should be prepared as early as possible after donation from each unit before the blood is refrigerated.each unit before the blood is refrigerated. Platelet concentrates can also be obtained directly by apheresisPlatelet concentrates can also be obtained directly by apheresis from a singlefrom a single donor by blood cell processor.donor by blood cell processor. Volume:Volume: a)a) Random( from blood unit ) : 50- 70 mlRandom( from blood unit ) : 50- 70 ml b) Apheresis platelet: 200- 350 mlb) Apheresis platelet: 200- 350 ml Storage:Storage: 20 – 2420 – 2400 C for 5 days using an platelet agitatorC for 5 days using an platelet agitator Platelets lose their haemostatic function within 24- 48Platelets lose their haemostatic function within 24- 48 hours storage at 4hours storage at 400 C.C. Platelet content:Platelet content: a) Random : 5.5x 10a) Random : 5.5x 101010 platelet/unitplatelet/unit b) Apheresis: 3x10b) Apheresis: 3x101111 platelet/unitplatelet/unit
- 32. INDICATIONS OF PLATELET TRANSFUSIONINDICATIONS OF PLATELET TRANSFUSION 1. Chronic stable thrombocytopenia (no bleeding) with1. Chronic stable thrombocytopenia (no bleeding) with platelet count <10,000/µlplatelet count <10,000/µl 2. Thrombocytopenia with active bleeding with platelet count2. Thrombocytopenia with active bleeding with platelet count <50,000/µl<50,000/µl 3. Patients with bone marrow failure due to disease,3. Patients with bone marrow failure due to disease, chemotherapy or irradiation, count <20,000/µlchemotherapy or irradiation, count <20,000/µl 4. Prophylactic: Emergency surgery with platelet count4. Prophylactic: Emergency surgery with platelet count <50,000/µl,<50,000/µl, Excessive post operative bleeding.Excessive post operative bleeding. 5. Prevention of bleeding in Acute leukaemia5. Prevention of bleeding in Acute leukaemia 6. NICU infants with platelet count <100,000/µl6. NICU infants with platelet count <100,000/µl 7. Functional platelet disorders.7. Functional platelet disorders. 8. Massive blood transfusion where platelet count8. Massive blood transfusion where platelet count <50,000/µl<50,000/µl 9. Severe bleeding in DIC, Liver disease, platelet count < 50,000/µl9. Severe bleeding in DIC, Liver disease, platelet count < 50,000/µl
- 34. RecommendationRecommendation Platelet Transfusion is rarely indicated-Platelet Transfusion is rarely indicated- 1. In ITP, TTP, post transfusion purpura without bleeding.1. In ITP, TTP, post transfusion purpura without bleeding. 2. In Untreated DIC, thrombocytopenia due to septicemia2. In Untreated DIC, thrombocytopenia due to septicemia or hyperplenism unless there is active bleedingor hyperplenism unless there is active bleeding DOSE:DOSE: 1. One unit random platelet will increase 5000-10000/µl1. One unit random platelet will increase 5000-10000/µl 2. one platelet pheresis unit will increase 30,000- 60,000/µl2. one platelet pheresis unit will increase 30,000- 60,000/µl Adult dose:Adult dose: a) One Plt. Concentrate /10 kg body weight ( 6- 8a) One Plt. Concentrate /10 kg body weight ( 6- 8 units)units) b) One Platelet pheresis unitb) One Platelet pheresis unit Pediatric dose:Pediatric dose: One Plt. Concentrate /7- 10kg body weight (5-One Plt. Concentrate /7- 10kg body weight (5- 10ml/kg)10ml/kg) Number of units:Number of units: (Desired plt. count – initial plt. count) x BSA /10(Desired plt. count – initial plt. count) x BSA /10 *The recovery of Platelets after one hour of transfusion in healthy*The recovery of Platelets after one hour of transfusion in healthy person is approximately 65%.person is approximately 65%.
- 35. Platelet concentratesPlatelet concentrates Administration:Administration: 1. Filter administraton set1. Filter administraton set 2. ABO matched platelet if RBC > 2ml contamination in 1 unit.2. ABO matched platelet if RBC > 2ml contamination in 1 unit. 3. Rh negative patient will receive platelets from Rh negative donor. Hazards: 1. Allo-immunization1. Allo-immunization 2. Refractoriness ( Platelet increament will be less2. Refractoriness ( Platelet increament will be less than 50% after platelet transfusion due tothan 50% after platelet transfusion due to presence of HLA or platelet antibody ).presence of HLA or platelet antibody ).
- 36. LEUCOCYTE CONCENTRATELEUCOCYTE CONCENTRATE • It should be prepared within 4 hrs of collection of blood as aIt should be prepared within 4 hrs of collection of blood as a buffy coat.buffy coat. • It is stored at 20- 24ºIt is stored at 20- 24ºсс & should be administered within 24 hrs& should be administered within 24 hrs of collection.of collection. • Each buffy coat unit contain 0.6x10Each buffy coat unit contain 0.6x1099 /L/L granulocytesgranulocytes • Leucocytes concentrates can be collected from a single donorLeucocytes concentrates can be collected from a single donor by granulocytopheresis (1.0X 10by granulocytopheresis (1.0X 1099 /L granulocytes)/L granulocytes) • Granulocytes have shelf life of 24 hrs.Granulocytes have shelf life of 24 hrs. • It should be ABO & Rh group specific ( same blood group)It should be ABO & Rh group specific ( same blood group)
- 37. Leucocytes ConcentrateLeucocytes Concentrate INDICATIONS:INDICATIONS: 1. Severe neutropenia after taking chemotherapy for leukaemia & bone1. Severe neutropenia after taking chemotherapy for leukaemia & bone marrow transplantmarrow transplant 2. Severe bacterial or fungal infection when there is good evidence that2. Severe bacterial or fungal infection when there is good evidence that antibiotics have failed.antibiotics have failed. 3. Granulocytes count less than 0.2 x 103. Granulocytes count less than 0.2 x 1099 /L, no recovery with therapy/L, no recovery with therapy DOSE:DOSE: 1- 2 X 101- 2 X 1099 granulocytes /kg body weightgranulocytes /kg body weight ABO & Rh compatible.ABO & Rh compatible. Storage:Storage: At RT( 22- 25ºAt RT( 22- 25ºсс) for 24 hours) for 24 hours UNTOWARDS EFFECTS:UNTOWARDS EFFECTS: 1.Febrile Non Haemolytic Transfusion Reactions (FNHTR)1.Febrile Non Haemolytic Transfusion Reactions (FNHTR) 2. Pulmonary infiltrations2. Pulmonary infiltrations 3. Allo-immunization3. Allo-immunization 4. Graft versus host disease (GVHD) due to lymphocytes engraftment4. Graft versus host disease (GVHD) due to lymphocytes engraftment
- 38. FRESH FROZEN PLASMA (FFP)FRESH FROZEN PLASMA (FFP) • Plasma can be separated from a single unitPlasma can be separated from a single unit of blood within 7- 8 hrs. after donation &of blood within 7- 8 hrs. after donation & rapidly frozen. It contain 150 – 250 ml ofrapidly frozen. It contain 150 – 250 ml of plasma.plasma. • Plasma can be collected by plasma pheresisPlasma can be collected by plasma pheresis from a single donor up to 500 ml of plasmafrom a single donor up to 500 ml of plasma and then rapidly frozen.and then rapidly frozen. • Rich in the clotting factors V & VIII, proteins , complement and immunoglobulins. • Good for 24 hours post thawing.
- 39. FRESH FROZEN PLASMA ( FFP )FRESH FROZEN PLASMA ( FFP ) INDICATIONS:INDICATIONS: 1. Patients with active bleeding with elevated PT & PTT1. Patients with active bleeding with elevated PT & PTT (>1.5 times )(>1.5 times ) 2. Patients of liver diseases with fibrinogen < 100mg/dl2. Patients of liver diseases with fibrinogen < 100mg/dl 3. Coumarin or Warfarin over doses.3. Coumarin or Warfarin over doses. 4. Liver transplant4. Liver transplant 5. Acute DIC5. Acute DIC 6. Congenital or acquired Coagulopathies with PT>18 sec6. Congenital or acquired Coagulopathies with PT>18 sec or coagulation factor assay <25%or coagulation factor assay <25%
- 40. UNTOWARD EFFECTS of FFPUNTOWARD EFFECTS of FFP 1.Urticaria1.Urticaria 2 Anaphylactoid reaction2 Anaphylactoid reaction 3.Circulatory overload3.Circulatory overload 4.FNHTR4.FNHTR CONTRA-INDICATIONS :CONTRA-INDICATIONS : -Volume expanders-Volume expanders -Nutrition-Nutrition -Wound healing-Wound healing DOSE:DOSE: -15- 30 ml/ kg body weight-15- 30 ml/ kg body weight --should be ABO & Rh group specificshould be ABO & Rh group specific - Should be thawed at 37º- Should be thawed at 37ºсс in water bath before use.in water bath before use. STORAGE:STORAGE: One year at – 18ºOne year at – 18ºсс to -80ºto -80ºсс
- 41. CRYOPRECIPITATECRYOPRECIPITATE • It is prepared from whole Blood or FFPIt is prepared from whole Blood or FFP • It is called cryo (cold) because it precipitates out ofIt is called cryo (cold) because it precipitates out of the plasma after deep freezing & slow thawing.the plasma after deep freezing & slow thawing. • Rich in Fibrinogen, Factor VIII, vWF, Factor XIII CONTENTS:CONTENTS: One unit of cryoprecipitate contain:One unit of cryoprecipitate contain: 1. Fibrinogen = 150 – 250 mg1. Fibrinogen = 150 – 250 mg 2. Fac.Vlll = 80 – 150 units ( 2 lU )2. Fac.Vlll = 80 – 150 units ( 2 lU ) 3. VWF = 80 – 120 units ( 40-70% of WB )3. VWF = 80 – 120 units ( 40-70% of WB ) 4. Fac. XIII =20 – 30% of WB4. Fac. XIII =20 – 30% of WB Volume:Volume: 25- 30 ml in one unit25- 30 ml in one unit
- 42. CRYOPRECIPITATECRYOPRECIPITATE INDICATIONS:INDICATIONS: 1. Fibrinogen deficiency <100mg/dl1. Fibrinogen deficiency <100mg/dl a) Congenitala) Congenital b) Acquired- DICb) Acquired- DIC 2. Uraemic & Hepatic patients to control bleeding2. Uraemic & Hepatic patients to control bleeding 3. Heamophilia A3. Heamophilia A 4. Von willebrand disease4. Von willebrand disease 5. Fac. XIII deficiency5. Fac. XIII deficiency
- 43. CRYOPRECIPITATECRYOPRECIPITATE Adult dose:Adult dose: pool of 10 bagspool of 10 bags or 1 unit/ 10 kg body weight.or 1 unit/ 10 kg body weight. Pediatric dose:Pediatric dose: 1 cryo unit/ 7- 10 kg. body weight.1 cryo unit/ 7- 10 kg. body weight. One unit of cryoprecipitate contain:One unit of cryoprecipitate contain: 1. Fibrinogen : 150 – 250 mg1. Fibrinogen : 150 – 250 mg 2. F.VIII : 80- 150 units ( 2 IU )2. F.VIII : 80- 150 units ( 2 IU ) 3. VWF : 40 – 70-%3. VWF : 40 – 70-% 4. F. XIII: 20- 30%4. F. XIII: 20- 30% Dose of Fac.VIII in HaemophiliaA & VWD:Dose of Fac.VIII in HaemophiliaA & VWD: BW X I / 2 (BW= body wt., I = desired increament in IU)BW X I / 2 (BW= body wt., I = desired increament in IU) STORAGE & SHELF LIFE:STORAGE & SHELF LIFE: One year at – 18 to - 80ºOne year at – 18 to - 80ºсс Thawing is in water bath at 37ºThawing is in water bath at 37ºсс Transfusion rate= 1- 2ml /minTransfusion rate= 1- 2ml /min
- 44. BLOOD COMPONENTSBLOOD COMPONENTS THERAPYTHERAPY Because of probable hazards, it is said- “BLOOD IS THE MOST DANGEROUS MEDICATION THAT A PHYSICIAN EVER PRESCRIBES” -LEWIS WADSWORTH NOVEMBER 2006
- 45. Contraindication of Blood TransfusionContraindication of Blood Transfusion Contraindication of BloodContraindication of Blood TransfusionTransfusion:: (Relative & Absolute)(Relative & Absolute) -High temperature-High temperature -High blood pressure-High blood pressure -Congestive cardiac failure-Congestive cardiac failure -Myocardial damage-Myocardial damage -Pulmonary edema-Pulmonary edema -Polycythaemia etc.-Polycythaemia etc. -Nutritional anaemia-Nutritional anaemia
- 46. Blood Group AntigenBlood Group Antigen
- 47. PlateletPlatelet