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Basics of Transfusion Therapy PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Basics of Transfusion Therapy”.

This medical PowerPoint presentation is about transfusion therapy, a medical treatment that involves the transfer of blood or blood components from one person (the donor) to another person (the recipient). This therapy is used to treat a wide range of medical conditions, including severe anemia, bleeding disorders, and certain types of cancer.

Blood transfusion is the most common form of transfusion therapy. During a blood transfusion, blood is taken from a donor and then transfused into the recipients bloodstream through a vein. Blood transfusions are usually given in a hospital or clinic setting and are closely monitored by medical professionals to ensure that the recipient is receiving the correct blood type and to watch for any adverse reactions.

In addition to blood transfusions, other forms of transfusion therapy include platelet transfusions, plasma transfusions, and cryoprecipitate transfusions. Platelet transfusions are used to treat bleeding disorders, while plasma transfusions are used to replace blood clotting factors. Cryoprecipitate transfusions are used to treat patients with low levels of fibrinogen, a protein that helps the blood to clot.

While transfusion therapy can be lifesaving, it is not without risks. Transfusions can cause allergic reactions, transfusion-related infections, and other complications. For this reason, doctors carefully weigh the benefits and risks of transfusion therapy before recommending it to their patients.

Tags : Transfusion Therapy, severe anemia, bleeding disorders, Hematology, Hematology PowerPoint presentation

Published on : May 29, 2023 | Views : 1668 | Downloads : 7

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Slide 1-

Basics of Transfusion Therapy Resident Education Lecture Series
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Hemoglobin Level and Symptoms HGB (GM%) SYMPTOMS 9-11 MINIMAL 7.5 EXERTIONAL DYSPNEA 6.0 WEAKNESS 3.0 DYSPNEA AT REST 2-2.5 HEART FAILURE LINMAN NEJM 279:812, 1968
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RBC Transfusion: Indications Acute Blood Loss Symptomatic Anemia Suboptimal O2 Capacity Exchange (SS, Co)
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RBC Transfusion: The Bathtub Principle Kidney Kidney Kidney 100 30 0 100 40 0 Blood Volume Blood Volume Blood Volume 100 30 0
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Pre-Transfusion Testing BLOOD TYPING: ABO, D Antigens only (Other antigens are weak immunogens) ANTIBODY SCREEN: Patient serum vs. cell panel CROSSMATCH Major: Patient Serum vs. Donor Cells
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RBC Products PRBC MOST TRANSFUSIONS WHOLE BLOOD ACUTE BLEEDING EXCHANGE PLASMA NEEDED WASHED REMOVE PLASMA FROZEN RARE RBC PHENOTYPE IRRADIATED IMMUNODEFICIENT CMV NEGATIVE IMMUNODEFICIENT SERONEGATIVE, NEONATE
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RBC Transfusion Volume Usual: Up to 15cc/Kg in 3-4 hours Unusual: Acute Hemorrhage: replace ongoing losses Chronic Anemia, Heart Failure, îBP 2cc/Kg/Gm HGB Diuretic Exchange
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Transfusion Volume 10cc/Kg PRBC 2.4 GM% in HGB 10cc/kg = X cc/kg 2.4 GM% Desired HGB rise PRBC cc = Blood Volume x (HGBF- HGBI) HGBT BV=70cc/KG, 80-90cc/KG newborn
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Hemolytic Transfusion Reactions Acute HTR 1/25,000 Fatal Acute HTR 1-4/1,000,000 Delayed HTR 1/5-10,000
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Symptoms and Signs of Acute Hemolytic Reactions Severe Back Pain Substernal Tightness, Dyspnea Hypotension / Circulatory collapse Vomiting, diarrhea Icterus Hemoglobinuria Renal shutdown Diffuse Oozing from wounds/punctures
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Response to Suspected Hemolytic Reaction Stop Transfusion Hydrate Specimens to Blood Bank Unit/Bag Serum Red cells Urine
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Acute Hemolysis: Diagnosis Do a direct antiglobulin test on post-transfusion sample Obtain post-transfusion blood and urine and inspect visually Recheck paperwork Recheck ABO type of unit and pre-and post-transfusion specimens Run urinalysis - to check for hemoglobinuria
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Cause of Acute HTR ABO incompatibility:source of error 10% at phlebotomy/labeling 23% in Transfusion Lab 67% transfusion administration (at the bedside)
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Nonhemolytic Transfusion Reactions Leukocyte Associated FNHTR Transfusion GVHD Neonatal Neutropenia Immunoglobulin Associated Urticaria/Fever Ig E TRALI Platelet Associated Post transfusion Purpura Neonatal Thrombocytopenia Metabolic/ Physical Citrate Toxicity Hypothermia Circulatory Overload Massive Transfusions Haemostatic Abnormalities Metabolic complications Hgb-O2 Curve Shift
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TRANSFUSION-RELATED INFECTION
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Risk of Transfusion-Transmitted Infection HIV 1 in 2,000,000 Hepatitis C 1 in 2,000,000 Hepatitis B 1 in 175,000 Hepatitis A Rare HTLV I/II 1 in 3,000,000 Bacteria 1/3,000 (for platelets) Malaria, T Cruzi, Babesia, Yersinia, Syphilis, Lyme, CJD, West Nile Virus…??
Slide 17-

Post Transfusion HCV Percent Number Incidence 5-10 150-300,000 Chronic 50 75-150,000 Cirrhosis 20 15-30,000
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Neonatal Post Transfusion CMV Incidence: 25% of seronegative infants receiving >50ml CMV seropositive blood Severity 50% severe or lethal manifestations
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Neonatal Transfusion CMV Prevention by Filtering Blood Seroconvert/Total Filtered PRBC: 0/30 Unfiltered PRBC: 9/42 Gilbert, L1:98:228, 1989
Slide 20-

Prevention of Post Transfusion Infection Don’t Transfuse Minimize Transfusion Limited Donors (dedicated units) Autologous Transfusions Erythropoetin Donor Screening: HIV Ab, HIV NAT, HCV Ab, HCV NAT, HBV Ag, Ab, HBc Ab, VDRL, West Nile NAT, HTLVI/II Ab, CMV Ab, Bacterial Culture (Platelets)
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Strategies to Decrease Operative RBC Transfusion Hemostasis Hemodilution Cell salvage DDAVP Autologous Transfusion Erythropoetin
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Neutropenia: infection risk 100 100-500 500-1000 1000 Relapse Remission Bodey. Ann Int Med 64:328, 1966.
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WBC Indications 2004 PMN: Newborn Sepsis Congenital/Acquired Neutropenia PMN Dysfunction Refractory Gram Negative Sepsis Ly: Disseminated Varicella-Zoster
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WBC transfusion:Logistics Donors Receive G-CSF +/- Decadron 2-3 Hour Cytapheresis 1010 Cells by Standards Donors pretested for ID markers Cells decay rapidly: limited value at > 6 hours post-collection Quantitative impact limited
Slide 25-

Fresh Frozen Plasma 200-250 ml of plasma containing all clotting factors, AT III, Protein C & S. Compatibility Important Can Give: A plasma to A or O patient B plasma to B or O patient O plasma to O patient AB plasma to anyone
Slide 26-

Indications: FFP Replacement of Coagulation Factors Abnormal Bleeding with coagulopathy Multiple factor deficiency: Liver disease DIC Reversal of Warfarin Dilutional Isolated factor deficiency-no concentrate Factor XI, XIII Replacement of regulatory proteins TTP, Hereditary angioedema Not indicated for: volume expansion, reversal of Heparin, correction of INR < 1.5
Slide 27-

Guidelines: FFP Use Usual dosing: Adult 10ml/Kg Peds 10-15ml/Kg 15-20% rise in factor levels Usually does not correct laboratory coagulation status to “normal”
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Cryoprecipitate 10-15 ml per unit (bag) Fibrinogen 250 mg Factor VIII 80-120 units Von Willebrand Factor 40-70% of FFP Factor XIII 20-30% of FFP Fibronectin 20-40 mg
Slide 30-

Cryoprecipitate: Dosing 1-2 Units / 10 Kg Expect 60-100 mg/dl rise in fibrinogen Goal: Fibrinogen 70-100 mg/dl
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Slide 33-

Platelets: Risk of Spontaneous Hemorrhage Count Site > 40,000 Minimal 20-40,000 GI Mucosa 5-20 Skin, Mucus Membranes < 5 CNS, Lung
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Slide 35-

0 10 20 30 40 0 50 100 150 200 250 300 Platelets (/microL) Bleeding time (min) ITP AA WAS ASA Uremia vWD Harker. NEJM 287:155, 1972.
Slide 36-

Prophylactic Platelet TX Guidelines Platelet Count/μl Recommendation 0-5,000 Always 5-10,000 If Febrile of Minor Bleeding 11-20,000 If coagulopathy or minor procedure >20,000 If Major Bleed or invasive procedure
Slide 37-

Transfused Platelets/Survival 6 units = 1 single donor unit (SDP); available as ¼, ½ and full SDP Dose: child 1 unit/5-6 kg adult 1 unit/8-10 kg Lifespan: 7-10 Days Native 2-3 Days Transfused Factors shortening Lifespan: Fever, Sepsis HLA, Platelet Specific Abs DIC Product Age?
Slide 38-

TRAP TrialEffect of Leukodepletion on Alloimmunization
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Slide 40-

When in Doubt: Call the Transfusion Service! 266-2119
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From ABP Certifying Exam Content Outline 2. Transfusion and collection of blood Understand the risk of transmitting infectious diseases during blood transfusion(s) Recognize that erythrocyte transfusions may be associated with hemolytic, febrile, and urticarial reactions Understand the role of erythrocyte transfusions in the management of anemia
Slide 42-

Credits Bruce Camitta MDM W Lankiewicz MD