Blood & its components

Whole blood.
The standard unit of whole blood contains 450ml of blood added to 50 to 60ml of liquid anticoagulant preservative ( CPDA-1) Citrate acts as the anticoagulant.( by binding calcium )

Dextrose is used as a fuel source for RBC.

phosphate is added to keep the Ph close to

normal ( acts as a buffer).

Adenosine

precursor for ATP.

Blood type ( ABO-Rh typing)

The membrane of human RBC contain a variety of antigen which is called agglutinogen. Antibodies against RBC agglutinogen are called agglutinins. Rh + individuals has antigen D (agglutinogen). Rh individuals has no D antigen. Unlike the antibodies of the ABO, system,anti-D antibodies do not develop without exposure of Rhindividual to Rh+ individual by transfusion or entrance of fetal blood in to the maternal circulation.

Contd
Blood type O A B AB antigen No antigen A antigen B antigen A & B antigen Antibody in plasma Anti A & anti B Anti B Anti A none Recipient O, A, B, AB A & AB B & AB AB

Features of whole blood.

Shelf life whole blood is 21 days, but the platelets lose their viability after 1 to 2 days Potassium is continually leaking from the RBC; Stored at 4 oc. Indicationactive hemorrhage. For a patient who requires platelets, the blood must be transfused within 6hrs. Of donation.

RBC concentrates (packed RBC) prepared by centrifuging whole blood.

Contains 200 ml of cells( both red & white cells. Used as a source of hemoglobin & not as a source of volume. Indicationanemia to increase oxygen carrying capacity. Storage life 21-31 days. Should be warmed to 37 deg. Cen.

plasma components
Fresh frozen plasma when packed red cells are separated from whole blood the remaining plasma fraction is stored at -18oc ( rapid freezing helps prevent inactivation of labile coagulation factors V & VII. FFP contains all plasma proteins including all clotting factors.

Contd
Indications 1.to provide coagulation factor. 2.to reverse warfarin effect. Compatibility testing is not necessary. Slow thawing of FFP yields a gelatinous precipitate ( cryoprecipitate) that contains high concentration of factors ( V & VII ) & fibrinogen. Once separated, this cryoprecipitate can be refrozen for storage. Once thawed, it must be transfused within 24 h.

platelets
Stored at room temperature, refrigeration decreases platelet viability. Should be used within 6hrs of blood donation. Should be administered with out filter. Used in thrombocytopenia or abnormal platelet function. ABO- compatible platelet transfusions are desirable but not necessary.

Cares during blood transfusion.

Compatibility testing. Viscosity should have to be reduced by 1. saline dilution. 2. blood warmers warming reduces the viscosity of refrigerated blood by 2 & times & it minimize the risk of hypothermia 3. by using pressurized infusions.

Massive transfusion.
Is defined as the replacement of an entire blood volume in 24 hrs. complications. 1. coagulopathy due to dilutional thrombocytopenia. 2. citrate toxicity leads to hypocalcaemia. 3. hypothermia.

Complication of blood transfussion.

Transmission of infection. Immune complications which is due to sensitization of the recipient to donor RBC ,WBC,platelets, or plasma proteins. Which leads to hemolytic reactions. 1.Hemolytic reactions involve specific destruction of the transfused RBC by the recipient,s antibodies 2.nonhemolytic reactions are due to sensitization of the recipient to the donor's WBC, platelets, or plasma proteins.( febrile reactions , urticarial reaction, anaphylactic reactions. Noncardiogenic pulmonary edema.

Emergency transfusion ( uncrossmatched blood)

People with type O blood have been called universal donors & their blood can be used in emergency transfusion when typing & or crossmatching is not available. However, some type O donors produce high titers of hemolytic IgG,IgM, anti-A, anti-A, & anti-B antibodies. High titers of these hemolysins in donor units are capabable of causing destruction of A or B RBCs of a non-type O recipient. Type O Rh- ,uncrossmatched packed RBCs should be used in preference to type O Rh- whole blood because PRBCs have smaller volumes of plasma & are almost free of hemolytic anti-A & anti-B antibodies.