输血-英语PPT课件.ppt

1、23 History Type of Transfusion Indication Transfusion Reactions Autologous transfusion Component Transfusion45 (1665)6Philip (1825)7Landsteiner (1900)8How to store blood longer?9Is there any suitable Blood Substitutes10Successful blood transfusion is relatively recent Crossmatching Anticoagulation P

2、lastic storage container11Type of Transfusion：nWhole Blood；nBlood Component；RBC PLT FFP Leukocyte concentrate nPlasma Substitutes；Use of whole blood is considered to be a waste of resources12 Symptomatic anemia (providing oxygen-carrying capacity) Transfusion trigger (HCT30% ; HB10g/dl) 1 Unit incre

3、ases 3% HCT or 1g/dl Shelf life =42 d (1-6 )13 Thrombocytopenia ( 50,000) Platelet dysfunction Each unit increase 5,000 PLTs after 1 H14 Profoundly granulocytopenia (500) Serious infection not responsive to antibiotic therapy15 Coagulation factor deficiencies 1 ml increases 1% clotting factors Being

4、 used as soon as possible Albumin, hetastarch, crystalliods are equally effective volume expander but safer than FFP After use of 5 U of RBCs, matching 2 U of FFP16-Volume ExpanderDextran Most widely used Low/Middle M.W. (40,000-70,000) Massive transfusion could impair coagulation Occasional ALLERGI

5、C reactionHydroxyethyl Starch Formulation (HES) More stable Containing essential electrolytes No allergic reaction17Indication：nAcute massive blood loss;nAnaemia and hypoalbuminemia;nOverwhelming Infection;nDysfunction of Coagulation;18Technique of Transfusion:nApproach Route:Peripheral Vein, Center

6、 VeinnFiltration before Transfusion：nVelocity of Transfusion：5-10ml/min19nDouble Check: Name, Type and CrossmatchnStorage Time: Citrate Phoshate DetroseAcidic Citrate Detrose 21D, 35DnPre-heat：nNo any other Medication：nObservation during / after Transfusion：AttentionAttention：20Incidence：2%Chills, F

7、ever 39-40.CHeadache, SweatinessNausea, Vomiting, Flushing15min-1hrFebrile Reactions ：21nImmuno-reaction ：nEndo-toxins：nContamination or Hemolysis：nAnalyze possible reasons：nStop Transfusion ：nGeneral Support：Treatment：Febrile Reactions ：22UrticariaAbdominal cramps DyspneaVomitingDiarrheaAnaphylacti

8、c reactions：23nImmuno-reaction： IgEnHereditary Immunoglobulin： IgAReason：nAdminister antihistaminesnAdminister epinephrine, diphenhydramine, and corticosteroids：nSupport airway and circulation as necessary：Treatment：Anaphylactic reactions：24Burning at the intravenous (IV) line siteFever, Chills, Dys

9、pneaShockCardiovascular CollapseHemoglobinuria, HemoglobinemiaRenal FailureDICHemolytic transfusion reactions 25nABO incompatibility nRh Incompatibility nNon-immune HemolysisnImmune Hemolysis Reasons：Hemolytic Transfusion Reactions 26nStop Transfusion as soon as reaction is suspectednCheck the name,

10、 type and crossmatchnUrine Exam nRenal Protection (Aggressive Fluid Resuscitation, Furosemide)nDIC MonitorTreatment：Hemolytic Transfusion Reactions 27nDouble Check name,type and crossmatchnOperate carefully and routinely nTemperature MonitorPrevention：Hemolytic Transfusion Reactions28Massive transfu

11、sion complications:Volume OverloadCongestive Heart Failure TachycardiaTachypneaCyanopathy29nVolume OverloadnHeart Functional FailurenLung Functional FailureReasons：nStop TransfusionnHeart Functional SupportnDiuresis (Furosemide)Treatment：Massive Transfusion Complications:30Contamination:FeverShockDI

12、CBacterial ContaminationReasons：31nStop TransfusionnBacterial Exam and Culture nAntibioticsTreatment：nDouble Check nOperate carefullyPrevention：Contamination:32nHepatitis B, Hepatitis CnHIVnCytomegalovirus (CMV)nSyphilisnMalariaAcquired diseases ：33p 经常不断地学习,你就什么都知道。你知道得越多,你就越有力量p Study Constantly, And You Will Know Everything. The More You Know, The More Powerful You Will Be学习总结34结束语当你尽了自己的最大努力时，失败也是伟大的，所以不要放弃，坚持就是正确的。When You Do Your Best, Failure Is Great, So DonT Give Up, Stick To The End演讲人：XXXXXX 时 间：XX年XX月XX日