Blood transfusion

General Surgery

Mosul university- College of dentistry-oral & maxillofacial surgery department
Dr. Ziad H. Delemi B.D.S, F.I.B.M.S (M.F.)
Blood Transfusion

Mosul university- College of dentistry-oral & maxillofacial surgery department

Types of blood
1-Banked whole blood: 25% of RBC died after 24hrs, another 25% die in 2weeks old blood, another 25% die in 4weeks old blood. So older blood: -more hemolysis -poor platelets -poor factor 8 -higher PH

Mosul university- College of dentistry-oral & maxillofacial surgery department

Types of blood
2-Fresh whole blood: should be given within 6 hrs. rich with factors 8&9. 3- Packed RBCs: useful in children, elderly patients. 4- Frozen RBCs: less risk of hepatitis, less antigenisity. 5-platelets: used for thrombocytopenia, DIC, massive blood loss.

Mosul university- College of dentistry-oral & maxillofacial surgery department

Types of blood

Mosul university- College of dentistry-oral & maxillofacial surgery department

Types of blood
10- antihemophlic concentrate: factor 8. 11- dissociated human fibrinogen: stored in dry form & when used mixed with distilled water used for DIC & afibrinogenemia.


Mosul university- College of dentistry-oral & maxillofacial surgery department
Methods of blood transfusion
1- intravenous IV: a- Auto transfusion: there is a time to collect blood from the patient & given to him when needed. b- Isotransfusion: usual way from donor to patient we can give up 1liter in short time without warming , blood given in 3-4 hrs. warming is needed in massive blood transfusion. 2- intraperitonial , intramedullary:

Technique of blood transfusion

Mosul university- College of dentistry-oral & maxillofacial surgery department
-blood group O- blindly could be used for very extreme emergency cases.3- blood substitutes: can be used until cross matching done ( colloid :Dextran, Hemacele, ..)When giving blood –check name carefully. -use sterile sets. -don't warm the blood.If warmed give the blood in 1-2 hrsSo t1\2 of the blood at room temp. 5-6 hrs Technique of blood transfusion

Mosul university- College of dentistry-oral & maxillofacial surgery department

1- replacement of blood loss due to: -trauma -hemorrhagic condition -major surgery with excessive blood loss 2- improvement of oxygen carrying capacity 3- replacement of clotting factors, in multifactorial cases give fresh blood or FFP, 4- pre-operative correction 5- miscellaneous: anemia, debilitation, sepsis,… Indication of blood transfusion

Mosul university- College of dentistry-oral & maxillofacial surgery department

1- hemolytic reaction A- major incompatibility reaction: due to giving mismatched blood (different gp.) (ABO incomp.) B- minor incompatibility reaction: due to error in minor gp.( Rh. Incomp.) There is intravascular destruction of RBCs lead to libration of heam from Hb & this will be deposited in the renal tubules lead to acute tubular necrosis & there will be a collapse of circulation
Complications of blood transfusion


Clinical picture: fever, rigor, chills, loin pain, hematuria, later anuria. Treatment: -stop the blood transfusion immediately. -large dose of Mannitol to enhance diuresis & prevent renal shut down. - IV fluid. -NaHCO3 to alkalinization of urine & dissolve heam from renal tubules -some times dialysis needed if above failed.
Complications of blood transfusion



2- allergic reaction: less dangerous due to any Ag in plasma or WBCs C\P: fever, itching, urticarial rash. Rx: IM antihistamine , IV hydrocortisone , SC adrenaline. 3- pyrexial reaction: due to pyrogens in the transfused blood causes fever & rigor , blood is good culture media of bacteria & sepsis. 4- bacterial sepsis: when blood kept outside refrigerator for long time.
Complications of blood transfusion


5- infections: syphilis malaria, HIV, HBV. 6- thrombophlebitis: from cannula 7- air embolism: rare bec. It needs 80ml to cause embolism.
Complications of blood transfusion