Blood transfusion

Blood transfusion is the process of transferring blood or blood components from one person (the donor) into the bloodstream of another person (the recipient). Transfusion is done as a life-saving procedure to replace blood cells or blood products lost through bleeding.

CONDITIONS WHEN BLOOD TRANSFUSION IS NECESSARY

Blood transfusion is essential in the following conditions:

1. Anemia

2. Hemorrhage

3. Trauma

4. Burns

5. Surgery.

PRECAUTIONS

Certain precautions must be followed before and during the transfusion of blood to a patient.

PRECAUTIONS TO BE TAKEN BEFORE THE TRANSFUSION OF BLOOD

1. Donor must be healthy, without any diseases like:

a. Sexually transmitted diseases such as syphilis

b. Diseases caused by virus like hepatitis, AIDS, etc.

2. Only compatible blood must be transfused

3. Both matching and cross-matching must be done

4. Rh compatibility must be confirmed.

PRECAUTIONS TO BE TAKEN WHILE TRANSFUSING BLOOD

1. Apparatus for transfusion must be sterile

2. Temperature of blood to be transfused must be same as the body temperature

3. Transfusion of blood must be slow. The sudden rapid infusion of blood into the body increases the

load on the heart, resulting in many complications.

HAZARDS OF BLOOD TRANSFUSION

Hazards of blood transfusion are of four types:

1. Reactions due to mismatched (incompatible) blood transfusion – transfusion reactions

2. Reactions due to massive blood transfusion

3. Reactions due to faulty techniques during blood transfusion

4. Transmission of infections.

REACTIONS DUE TO MISMATCHED BLOOD TRANSFUSION – TRANSFUSION REACTIONS

Transfusion reactions due to ABO incompatibility and Rh Incompatibility

REACTIONS DUE TO MASSIVE BLOOD TRANSFUSION

Massive transfusion is the transfusion of blood equivalent or more than the patient’s own blood volume. It leads to

i. Circulatory shock, particularly in patients suffering from chronic anemia, cardiac diseases or

renal diseases

ii. Hyperkalemia due to increased potassium concentration in stored blood

iii. Hypocalcemia leading to tetany due to massive transfusion of citrated blood

iv. Hemosiderosis (increased deposition of ion in the form of hemosiderin, in organs such as

endocrine glands, heart and liver) due to iron overload after repeated transfusions.

REACTIONS DUE TO FAULTY TECHNIQUES DURING BLOOD TRANSFUSION

Faulty techniques adapted during blood transfusion leads to:

i. Thrombophlebitis (inflammation of vein, associated with formation of thrombus).

ii. Air embolism (obstruction of blood vessel due to entrance of air into the bloodstream).

TRANSMISSION OF INFECTIONS

Blood transfusion without precaution leads to transmission of blood-borne infections such as:

i. HIV

ii. Hepatitis B and A

iii. Glandular fever or infectious mononucleosis (acute infectious disease caused by Epstein-

Barr virus and characterized by fever, swollen lymph nodes, sore throat and abnormal

lymphocytes)

iv. Herpes (viral disease with eruption of small blister-like vesicles on skin or membranes)

v. Bacterial infections.

BLOOD SUBSTITUTES

Fluids infused into the body instead of whole blood are known as blood substitutes.

Commonly used blood substitutes are:

1. Human plasma

2. 0.9% sodium chloride solution (saline) and 5% glucose

3. Colloids like gum acacia, isinglass, albumin and animal gelatin

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