Blood transfusions: procedures, indications and side effects

Blood transfusion is a procedure to get blood into the body of someone who is short of blood or in a medical procedure, such as surgery. This procedure can even save a person's life. Each transfusion process may require different blood components depending on the condition. Some need whole blood, some need only red blood cells. Some need only platelets, or only a portion of blood plasma. Check out the full review below.

Types of blood components that are given in the transfusion process

When seen with the naked eye, blood is a dark red liquid. However, in fact, when examined under a microscope, blood consists of many different components, namely red blood cells (erythrocytes), white blood cells (leukocytes), platelets (platelets / pieces of blood), and blood plasma.

Generally there are five types of blood components that can be channeled through this transfusion process. Prior to that, the collected donor blood will be sent to the laboratory to be processed and divided as needed, for example, bags of red blood cells, plasma, blood platelets and / or cryoprecipitate.

The types of blood components that are given in the transfusion process will depend on their needs and functions.

1. Whole blood (

As the name implies, complete whole blood contains all blood components, namely erythrocytes, leukocytes, platelets, and blood plasma. Whole blood administration is counted in units of blood bags, of which one unit contains about 0.5 liter or 500 ml.

Transfusion of whole blood is needed to replace red blood cells as soon as possible, for example in the case of a traffic accident that causes serious injury so that the blood loss is very large (more than 30% of body fluid volume).

A whole blood transfusion may also be performed to replace the large volume of blood lost during surgery.

2.Red blood cells (

One PRC bag contains 150-220 mL of red blood cells without any blood plasma. PRC transfusions are especially necessary for anemic patients, including anemia caused by pregnancy and childbirth.

People who are recovering from certain surgeries, accident victims, and those with blood disorders such as thalassemia and leukemia also need red blood cell donations from donors.

Recent guidelines published by the AABB (American Association of Blood Banks) also recommend PRC transfusion in inpatients who are stable but with blood hemoglobin (Hb) levels <7 g / dL, including ICU patients.

Meanwhile, patients who have recently undergone surgery and have a history of heart disease are advised to get a transfusion if their Hb level is less than 8 g / dL.

3.Platelet concentrate (

Platelets or platelets are colorless blood components that function for blood clotting.

It takes several donors at once to get a bag of platelets for platelet transfusions. The shelf life of platelet donors is also short.

This procedure is usually intended for people who have impaired platelet formation by the spinal cord and other platelet count and function disorders.

4. FFP (

FFP is a yellowish component of blood. FFP is a blood product that is processed from whole blood. FFP contains blood plasma components which contain blood clotting factors, albumin, immunoglobulin, and factor VIII (a blood clotting factor contained in plasma).

FFP can be useful for people with blood clotting disorders and to prevent excessive bleeding in blood thinning drug users (anticoagulants) who are about to undergo surgery.

5. Cryo-AHF (

Cryo-AHF aka cryoprecipitate is a portion of blood plasma that is very rich in clotting factors such as fibrinogen and factor VIII.

This blood component is used selectively for people with blood clotting factor disorders, such as type A hemophilia (factor VIII deficiency) or Von Willdebrand disease (a type of inherited blood disorder).

Preparation before blood transfusion

Patients who have to do blood transfusions don't really need to prepare anything. It's just that, before a blood transfusion is carried out, the patient's blood type and type must be known first. This can be determined by examining the blood in the laboratory.

After carrying out a blood type check, some things that may also be done before the transfusion, include:

• Examination of general health conditions, such as blood pressure, body temperature, and heart rate
• Eat nutritious, high-calorie foods to speed up recovery, such as chicken, beef, liver, and various dark green leafy vegetables.

What is the blood transfusion process like?

Blood transfusion is a medical procedure that has many risks. So, the gift must be directly under the supervision of medical personnel. The volume of blood that is distributed cannot be arbitrary, because it must be adjusted to the needs and the body's ability to accept it.

This procedure is performed by infusing blood into the body through a needle whose tube is connected to a blood bag. In principle, the process of a blood transfusion is similar to when you are on an IV, except that the bag contains blood.

This process will take about 30 minutes to 4 hours, depending on how many bags of blood you need to get into your body.

After going through the procedure, the health worker will check the vital signs in your body. During this process, your temperature and blood pressure may be monitored.

Quoted from Hopkins Medicine, you may be allowed to go home immediately after a blood transfusion. You will also soon be doing normal activities and eating a diet, as usual.

After that, you may be asked to do further blood tests. This process is done to determine how your body responds to the transfusion that you just passed.

Blood transfusion indications

Most hospitals have rules about how low a person's red blood cell level is before it is declared that a patient needs a transfusion. This rule is called the blood transfusion parameter.

This transfusion parameter will also affect whether a person has an indication for blood transfusion or not.

In general, quoted from the American Family Physician, signs or indications that someone needs a blood transfusion are:

• Anemia with symptoms of shortness of breath, dizziness, congestive heart failure, and can not tolerate sports activities
• Acute sickle cell anemia
• Blood loss is more than 30 percent of the volume of blood in the body

Blood plasma infusions can be used to reverse the anticoagulant effect. Meanwhile, platelet transfusions can also be done to prevent bleeding in patients with abnormal platelet function.

Research shows that not doing blood transfusions in people who have an Hb above 7 and 8 grams per deciliter (g / dL) contributes to reduced mortality, length of stay in hospital and faster recovery.

Are there any side effects from blood transfusions?

So far, if the transfusion is done according to the correct medical standards, it will not endanger health at all. You may experience mild blood transfusion side effects, such as:

• Headache
• Fever
• Feel itchy
• It's a little hard to breathe
• Red skin

Meanwhile, side effects that rarely appear - but can still occur, namely:

• It's hard to breathe
• Chest pain
• Suddenly the blood pressure drops

Although rare, this procedure can still cause complications. Complications are possible especially during massive blood transfusions, when the patient receives 4 units of red blood cells in one hour, or more than 10 units in 24 hours.

Conditions that usually require massive blood transfusions are accidents, bleeding after surgery, to postpartum hemorrhage. Potential complications from this procedure include:

• Electrolyte abnormalities
• Hypothermia (low body temperature)
• Blood clotting
• Metabolic acidosis, in which the body fluids contain too much acid
• Stroke or heart attack

If you have had more than one transfusion, you are more likely to have a compromised immune system. This is caused by the reaction of your immune system to the blood that has just entered the body. However, this condition is rare and can be prevented by checking your blood type beforehand, so that the blood that is transfused is sure to match the body.

If you experience or feel any symptoms or health problems during the procedure, do not hesitate to inform the medical team who treats you.