Scribd
Upload
179 views28 pages

Blood Transfusion

The document discusses blood transfusion in pediatric practice, including the history of blood transfusion, components of blood that can be transfused, indications for transfusion, dosages, and potential risks and complications of transfusion like transfusion reactions, infections, and side effects. It emphasizes using blood components instead of whole blood when possible, and approaches to reduce transfusion needs such as hematinics and erythropoietin.

Uploaded by

hanibalbal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
179 views28 pages

Blood Transfusion

The document discusses blood transfusion in pediatric practice, including the history of blood transfusion, components of blood that can be transfused, indications for transfusion, dosages, and potential risks and complications of transfusion like transfusion reactions, infections, and side effects. It emphasizes using blood components instead of whole blood when possible, and approaches to reduce transfusion needs such as hematinics and erythropoietin.

Uploaded by

hanibalbal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 28

BLOOD TRANSFUSION IN

PEDIATRIC PRACTICE

Djajadiman Gatot
Division of Hematology and Oncology
Department of Child Health
FMUI – Dr. CMGH
BLOOD TRANSFUSION
Transfer process of blood
from donor to recipient

History of blood transfusion


15th century – idea of blood transfusion
by drinking the blood
16th century – animal  animal
17th century – animal  human
18th century – human  human (direct route)
1901 – Karl Landsteiner found the ABO blood
group
1914 – the use of anticoagulant
1937 – blood banking organization
BLOOD
“Blut ist ein ganz besondrer Saft”
Blood is a very special fluid
Goethe, 1808
Current concept:
Blood is an Organ
• Transport system
• Defense system
• Coagulation system
Clinical blood transfusion

 Whole blood
 Blood component (1960)
~ Erythrocyte (red blood cell)
~ Leukocyte
~ Thrombocyte (Platelet)
~ Plasma (fresh frozen)
~ Cryoprecipitate
The advantage of transfusion
using blood component

Give only component needed


Prevent the administration of component
not needed (for safety and efficiency)
Positive impact on blood donor stock
The transfusion trigger,
when blood must be given

Acute anemia
 Hb ≤ 6 g/dL
 blood volume ↓: 30% - 40%
 Pre-operative (Hb<8g/dL)
 Chronic anemia
 Neonate with respiratory distress
BLOOD COMPONENT

Red blood cell (RBC)

• Whole blood
 Cardiac surgery
 Massive hemorrhage/bleeding
• Packed red cell (PRC)
 Source: single donor
 Ht ~ 55%
 Symptomatic anemia
…………rbc

• Leukocyte-depleted RBC
 filtered transfusion
 prevent: transfusion reaction, TTD and
GVHD
• Washed RBC
 diminished: antibody, K+, leukocyte
 given for: repeated transfusion, antibody
present, PNH
............ rbc

• Frozen-thawed, deglycerolized RBC


 remove glycerol, plasma, anticoagulant,
platelet debris and leukocyte
 for “antigen-matched” transfusion
• Irradiated RBC
 eliminate lymphocyte
 prevention of GVHD
Dose of RBC for transfusion
Patient’s Hb Amount of RBC
(g/dL) (given within 3-4 hrs)
-------------------------------------------------------------------------------
7-10 10 mL/kg.bw
5-7 5 mL/kb.bw*
< 5, CF (-) 3 mL/kg.bw*
< 5, CF (±) 3 mL/kg.bw+furosemide
< 5, CF (+) exchange transfusion
-------------------------------------------------------------------------------
CF= cardiac failure
*may be repeated at interval 6-12 hrs
Volume of blood needed

Whole blood:
BW(kg) x 6 x (Hbdesired – Hbobserved)

PRC(2/3 of whole blood):


BW(kg) x 4 x (Hbdesired – Hbobserved)
Platelet concentrate
(thrombocyte concentrate=TC)

 produced:
~ from1 unit of fresh whole blood, single donor
~ by thrombopheresis
 given in case of:
 bleeding with thrombocytopenia
 pre-operative preparation if platelet count low
 dosage (unit):
BW(kg) x 1/13(lt) x (1000/300)
Granulocyte suspension
(Buffy coat)

Indicated for:
 neonates with sepsis,
granulocytes < 3000/µL
 sepsis with granulocytes < 500/µL
 granulocyte dysfunction with infection

(The AABB)
Fresh Frozen Plasma

 Deficiency of clotting factors


 Hypovolemic shock (bleeding >>)
 Liver disease
 Immune deficiency
 Protein-losing enteropathy
Dose: 20-40 mL/kgBW
Cryoprecipitate

 1 bag (± 20 mL) of cryoprecipitate contain:


~ 80-120 units of factor VIII
~ 150-200 mg fibrinogen
~ von Willebrand factor
~ factor XIII
 for treatment of:
 hemophilia A
 von Willebrand disease
…………cryoprecipitate

Dosage:
 40-50 U/kgBW, loading dose
 20-25 U/kgBW, every 12 hrs
Factor VIII concentrate:
 Available as commercial product
 Contain approx. 250 U and 1000 U,
lyophilized with 10 mL diluents
Factor IX complex
(Activated prothrombin complex)

 Contain prothrombin, factor VII, IX, X


and protein C
 For treatment of hemophilia B, liver disease
 Dosage: 80-100 U/kgBW every 24 hrs
Albumin

Indications:
 Hypoproteinemia
 Severe burn
 Neonatal hyperbilirubinemia
Dosage: 1-3 g/kgBW
Immunoglobulin
Indications:
 for treating specific infections,
such as varicella, hepatitis B, etc.
 immune deficiency or immunocompromise
 immune thrombocytopenic purpura (ITP)
Dosage: 1-3 mL/kgBW
Autologous blood transfusion

Indicated for:
 Patient with persistent antibody
 Refuse to receive blood from others
Transfusion reaction

 Not always can be prevented


 Several types of transfusion reaction
 Symptoms not rarely overlapped

‫ ٭‬In case of transfusion reaction the following steps


must be anticipated:
 stop the transfusion immediately
 I.V. line should be kept running (with NaCl 0,9%)
 urgently inform the physician in charge and the
blood bank
Acute hemolytic transfusion reaction

ABO incompatibility
Symptoms: feverish, shivering, nausea,
dyspnea, chest and or abdominal
pain, oliguria, hemoglobinuria,
hypotension
severe: shock, DIC, renal failure
Slow hemolytic transfusion reaction

 present of antibody
 could be mild or severe
Non-hemolytic transfusion reaction

Fever
 Allergic reaction
 Anaphylaxis reaction
The aim to reduce the need
of blood transfusion

By the use of:


• Hematinics for deficiency anemia
• Erythropoietin (rHuEPO)
• Granulopoietin (G-CSF, GM-CSF)
• DDAVP for mild hemophilia
Other side effects and hazards
of blood transfusion
Transmission of infectious disease:
♦ Viral hepatitis
♦ HIV/AIDS
♦ CMV
♦ Others: ~ Malaria
~ Toxoplasmosis
~ HTLV-1
~ Infectious mononucleosis
~ Creutzfeld Jacob Disease
~ Parvo virus B 19
…………side effects

 Bacterial contamination
 Graft-versus- host disease
 Iron overload
Pearl

 Any transfusion which is not indicated is


contra indicated
 Adequate knowledge and skill in the
transfusion medicine are needed

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy