Know Your Blood Transfusion

Blood transfusion procedures had been going on since hundreds of years ago. There are various versions of the question when the first transfusion procedures performed. Narrated experiment was first performed blood transfusions in the 15th century. In the year 1492, Pope Giovanni Cibo seriously ill and was in a coma. Various recovery efforts carried out but nothing worked. Then came a doctor named Abraham Meyre and promised to save the Pope Giovanni Cibo by way of blood transfused. Finally, the chosen shepherd children 3 people aged 10 years and performed blood transfusions. At that time the transfusion done through the mouth, because the concept of circulation and intravenous access method is not known. Unfortunately, the three shepherd children had died some time after the transfusion process, while the Pope's condition did not improve and eventually died. Knowledge of blood transfusion began to grow since the theory of blood circulation by the physician William Harvey in the year 1613. Since then the practice of blood transfusion between animals began tested. However, human trials of transfusion to always meet a fatal outcome. To-human blood transfusion was first performed by dr. Jean-Baptiste Denis, a doctor of King Louis XIV of France, who did the blood transfusion to a child 15 years old who was ill in 1667. Knowledge of the growing blood transfusion in the early decades of the 19th century, with the discovery of blood groups. In the year 1818, dr. James Blundell, a gynecologist from the UK, for the first time managed to do a blood transfusion between humans for the treatment of postpartum hemorrhage. He used the blood of the patient's husband as a donor. Definition of Blood Transfusion Blood transfusion is the transfer of blood from one person (donor) into another person's blood vessels (recipient). This is usually done as a lifesaving maneuver (life-saving) to replace blood lost due to heavy bleeding, during surgery when blood loss or to increase the amount of blood in patients with anemia. Blood consists of blood cells and blood plasma. Blood cells consist of red blood cells (erythrocytes), white blood cells (leukocytes) and platelets, whereas the blood plasma contains water, protein, glucose, minerals, fibrinogen and coagulation factors of coagulation factors I-XIII. Erythrocytes in the hemoglobin molecule is very important. Hemoglobin is useful for "binding" of oxygen in the lungs and the "release" of oxygen to the organs that need it. Can be said, blood is an important component in the body. Through the blood, oxygen will be transported to all organs, especially the vital organs, so that its functions can continue to run. Therefore, blood transfusion procedure is an act that is essential for the survival of a person. Blood Component Transfusion Whole blood Whole blood (complete blood) is usually reserved only for transfusion in massive bleeding. Whole blood is given to ordinary acute bleeding, hypovolaemic shock and major surgery with bleeding> 1500 ml. Whole blood will increase the oxygen transport capacity and increased blood volume. Transfusion of one unit of whole blood will increase the hemoglobin 1 g / dl. Packed Red Blood Cell (PRBC) PRBC contain the same hemoglobin with whole blood, the difference is the amount of plasma, which contains fewer PRBC plasma. This causes the PRBC hematocrit levels higher than whole blood, ie 70% compared to 40%. Ordinary PRBC administered to a patient with slow bleeding, anemia or patients in cardiac abnormalities. We want to use, PRBC first need to be warmed up with body temperature (37 º C). if not heated, will complicate the transfer of oxygen from blood to organs. Fresh Frozen Plasma (Fresh Frozen Plasma) Fresh frozen plasma (FFP) contains all plasma proteins (clotting factors), especially V and VII factors. Regular FFP given after massive blood transfusion, after warfarin therapy, and coagulopathy in liver disease. Each unit of FFP usually can raise their levels of clotting factors of 2-3% in adults. Same with PRBC, as would be given to patients should be warmed beforehand according to body temperature. Platelets Platelet transfusion is indicated in patients with severe thrombocytopenia (<20,000> Kriopresipitat Kriopresipitat contain factor VIII and fibrinogen in large quantities. Kriopresipitat indicated in patients with hemophilia (factor VIII deficiency) and also in patients with fibrinogen deficiency. Complications of Blood Transfusion and Handling Hemolytic reaction The reaction is usually the destruction of red blood cells by the donor and recipient antibodies usually occurs because of the ABO blood group incompatibility that can identify an error caused by the patient, type of transfusion of blood or units. In the conscious, experienced symptoms of chills, fever, chest pain and nausea. In the unconscious or sedated, symptoms of increased body temperature, heart palpitations, low blood pressure and hemoglobinuria. Severity of symptoms depends on how much blood is transfused incompatible. Non-hemolytic reaction This reaction occurs because the recipient sensitization of white blood cells, platelets or plasma proteins from the donor. Symptoms include fever, hives are characterized by redness, red spots and itching without fever, anaphylactic reaction, pulmonary edema, hyperkalemia and acidosis. Infection Risk of infectious disease transmission through blood transfusion depends on many things, among others; the incidence of disease in the community, the effectiveness of screening is done, recipient immune system and the amount of each unit of blood donors. Some common infections are hepatitis virus, and HIV, Citomegalovirus bacterium Staphylococcal, yesteria and the malaria parasite. Prevent transfusion complications:

1. Stop transfusion
2. Raise blood pressure with intravenous fluids, if necessary add drugs.
3. Give 100% oxygen
4. Provision of diuretic drugs or mannitol furosemid
5. Antihistamine drugs
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7. Check for gas analysis and blood pH.