Transfuzje, Medycyna, Interna, Hematologia
[ Pobierz całość w formacie PDF ]BLOOD TRANSFUSION
Agnieszka Piekarska, MD
Department
Agnieszka Piekarska, MD
Department
of
of
Hematology
Hematology
and
and
Transplantology
Medical
Transplantology
Medical
University
University
of
of
Gdansk
Gdansk
COMPONENTS OF BLOOD
Red
blood
blood
cells
cells (
RBCs
RBCs)
Red
1.
Platelet
concentrates
concentrates
(PLT)
(PLT)
Platelet
2.
random-
donor
donor
platelets
platelets
random
single-
donor
donor
platelets
platelets -
apheresis
apheresis
single
Plasma
FFP
Plasma
3.
FFP
cryoprecipitate=antihemophilic
cryoprecipitate=antihemophilic
factor
factor
Granulocytes
4.
INDICATIONS FOR
TRASFUSION
INDICATIONS FOR
TRASFUSION
-
-
RBCs
RBCs
Individual
indications
indications
(
e.g.age
e.g.age
,
,
symptoms
symptoms
,
,
risk
risk
of
of
cardiac
cardiac
,
,
Individual
cerebral
or
or
respiratory
respiratory
complications
complications)
cerebral
Symptomatic
anaemia
anaemia
Symptomatic
¡
Blood
loss
loss
> 15%
> 15%
total
total
blood
blood
volume
volume
Blood
¤
Chronic
hypoproliferative
hypoproliferative
anaemia
anaemia (
e.g.MDS
e.g.MDS
)
)
Chronic
¤
critical
:
critical
:
Hb
Hb 8
(
7-
9
9
g/dl)
g/dl)
Ht
Ht
24
24
(
21
21 -
27
27
%)
%)
Sickle
cell
cell
disease
disease (
hemolysis
hemolysis
,
,
intravascular
intravascular
clogging
clogging
,
,
Sickle
¤
splenic
crisis
crisis
,
,
stroke
stroke)
splenic
CROSS-
MATCHING
MATCHING
TEST!
TEST!
(
blood
blood
groups
groups
compatibility
compatibility)
CROSS
One unit °
Hb
Hb
1-
1,5
1,5
g/dl //
g/dl //
Ht
Ht
2-3
%
One unit
INDICATIONS FOR
TRASFUSION
INDICATIONS FOR
TRASFUSION
-
-
PLT
PLT
<10
G/l (
G/l (
risk
risk
of
of
mucosal
mucosal
and
and
spontaneous
spontaneous
1.
<10
1.
bleeding Î
CNS!)
CNS!)
bleeding
10-
20
20
G/l (
G/l (
individual
individual -
infection
infection
, DIC,
, DIC,
bleeding
bleeding
,
,
2.
10
2.
purpura)
Surgery-
30
30-
50
50
G/l
G/l
3.
Surgery
3.
ABO
compatibility
compatibility
ABO
(!
Rh
Rh
-
Rh
Rh (-
)
)
women
women
at
at
child
child-
bearing
bearing
age
age)
(!
1j/10kg
Contraindications
1j/10kg
Contraindications
:
:
ITP, HIT, TTP
ITP, HIT, TTP
Refractory
response
response
to PLT
to PLT
transfusion
transfusion
Refractory
(
splenomegaly
splenomegaly
, DIC,
, DIC,
sepsis
sepsis
,
,
bleeding
bleeding
,
,
immunization
to HLA
to HLA
or
or
PLT
PLT-
specific
specific
Ag)
Ag)
immunization
INDICATIONS FOR
TRASFUSION
INDICATIONS FOR
TRASFUSION
-
-
Plasma
Plasma
Coagulation
factor
factor
deficiency
deficiency
1.
Coagulation
1.
Reversal
of
of
warfarin
warfarin
anticoagulation
anticoagulation
Reversal
2.
Dilutional
coagulopathy
coagulopathy (
e.g
e.g
.
.
massive
massive
3.
Dilutional
3.
blood
trasfusion
trasfusion)
blood
Hemorrhage
in
in
liver
liver
disease
disease
4.
Hemorrhage
4.
Thrombotic
thrombocytopenic
thrombocytopenic
purpura
purpura
Thrombotic
5.
Disseminated
intravascular
intravascular
coagulation
coagulation
(?)
(?)
6.
Disseminated
6.
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