输血 英语课件.ppt

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1、Blood transfution,2,Blood Transfusion,3,HistoryType of TransfusionIndicationTransfusion ReactionsAutologous transfusion Component Transfusion,Blood Transfusion,4,History and Significance,5,Lower (1665),First blood transfusion,6,Philip (1825),First human blood transfusion,7,Landsteiner (1900),Discove

2、ry of ABO type,8,How to store blood longer?,World war I,9,Is there any suitable Blood Substitutes,World war II,10,Successful blood transfusion is relatively recent,CrossmatchingAnticoagulationPlastic storage container,Blood Transfusion,11,Type of Transfusion：,Whole Blood；Blood Component；RBC PLT FFP

3、Leukocyte concentrate Plasma Substitutes；,Use of whole blood is considered to be a waste of resources,Blood Transfusion,12,Symptomatic anemia (providing oxygen-carrying capacity)Transfusion trigger (HCT30% ; HB10g/dl)1 Unit increases 3% HCT or 1g/dlShelf life =42 d (1-6 ),Red Blood Cells,13,Thromboc

4、ytopenia ( 50,000)Platelet dysfunctionEach unit increase 5,000 PLTs after 1 H,Platelets,14,Profoundly granulocytopenia (500)Serious infection not responsive to antibiotic therapy,Granulocytes,15,Coagulation factor deficiencies1 ml increases 1% clotting factorsBeing used as soon as possibleAlbumin, h

5、etastarch, crystalliods are equally effective volume expander but safer than FFPAfter use of 5 U of RBCs, matching 2 U of FFP,Fresh Frozen Plasma (FFP),16,-Volume Expander,DextranMost widely usedLow/Middle M.W. (40,000-70,000)Massive transfusion could impair coagulationOccasional ALLERGIC reactionHy

6、droxyethyl Starch Formulation (HES)More stableContaining essential electrolytesNo allergic reaction,Plasma Substitutes,17,Indication：,Acute massive blood loss;Anaemia and hypoalbuminemia;Overwhelming Infection;Dysfunction of Coagulation;,Blood Transfusion,18,Technique of Transfusion:,Approach Route:

7、Peripheral Vein, Center VeinFiltration before Transfusion：Velocity of Transfusion：5-10ml/min,Blood Transfusion,19,Double Check: Name, Type and CrossmatchStorage Time: Citrate Phoshate DetroseAcidic Citrate Detrose 21D, 35DPre-heat：No any other Medication：Observation during / after Transfusion：,Atten

8、tion：,Blood Transfusion,20,Incidence：2%Chills, Fever 39-40.CHeadache, SweatinessNausea, Vomiting, Flushing15min-1hr,Febrile Reactions ：,Transfusion Reactions,21,Immuno-reaction ：Endo-toxins：Contamination or Hemolysis：,Analyze possible reasons：Stop Transfusion ：General Support：,Treatment：,Febrile Rea

9、ctions ：,Transfusion Reactions,22,UrticariaAbdominal cramps DyspneaVomitingDiarrhea,Anaphylactic reactions：,Transfusion Reactions,23,Immuno-reaction： IgEHereditary Immunoglobulin： IgA,Reason：,Administer antihistaminesAdminister epinephrine, diphenhydramine, and corticosteroids：Support airway and cir

10、culation as necessary：,Treatment：,Anaphylactic reactions：,24,Burning at the intravenous (IV) line siteFever, Chills, DyspneaShockCardiovascular CollapseHemoglobinuria, HemoglobinemiaRenal FailureDIC,Hemolytic transfusion reactions,Transfusion Reactions,25,ABO incompatibility Rh Incompatibility Non-i

11、mmune HemolysisImmune Hemolysis,Reasons：,Hemolytic Transfusion Reactions,26,Stop Transfusion as soon as reaction is suspectedCheck the name, type and crossmatchUrine Exam Renal Protection (Aggressive Fluid Resuscitation, Furosemide)DIC Monitor,Treatment：,Hemolytic Transfusion Reactions,27,Double Che

12、ck name,type and crossmatchOperate carefully and routinely Temperature Monitor,Prevention：,Hemolytic Transfusion Reactions,28,Massive transfusion complications:,Volume OverloadCongestive Heart Failure TachycardiaTachypneaCyanopathy,Transfusion Reactions,29,Volume OverloadHeart Functional FailureLung

13、 Functional Failure,Reasons：,Stop TransfusionHeart Functional SupportDiuresis (Furosemide),Treatment：,Massive Transfusion Complications:,30,Contamination:,FeverShockDIC,Bacterial Contamination,Reasons：,Transfusion Reactions,31,Stop TransfusionBacterial Exam and Culture Antibiotics,Treatment：,Double

14、Check Operate carefully,Prevention：,Contamination:,32,Hepatitis B, Hepatitis CHIVCytomegalovirus (CMV)SyphilisMalaria,Acquired diseases ：,Transfusion Reactions,33,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,