Blood transfusion is a life saving procedure, but it should be done after weighing the benefits-to-risks factors. Transfusion should be decided only when the benefits outweigh the risks, according to Dr S.Viveka Priyadharshni, Transfusion Medicine, KG Hospital.
She made this observation in her power-point presentation on the topic “Appropriate use of blood and blood products” given to the post-graduate medical students at KG Hospital Auditorium recently.
Dr Priyadharshni said that “the indications for requirement of blood transfusion are– massive bleeding associated with trauma and surgery; exchange transfusion; patients with haemorrhagic shock and pulmonary diseases and at the time of cardio vascular surgeries.”
She emphatically said that blood transfusion should not be given for the feel of well being. Nutritional anaemia should better be controlled with medicines and not by transfusion. Blood transfusion would some time decrease body’s immunity.
She noted that blood transfusion could be avoided by prevention and early correction of anaemia, using alternatives, and by good anaesthetic and surgical management. She said, “KG Hospital is equipped with Aphresis, the equipment that splits whole blood into its components such as red blood cells, platelets and cryoprecipitate.”
“The equipment enables withdrawal of the whole blood from the donor, segregates the required component and returns the reminder to the donor. The procedures for component-wise separation are called Erythrocytapheresis (red blood cells), Plateletpheresis (platelets), Leucopheresis (white blood cells), Plasmapheresis (plasma) and Hematopoietic stem cell apheresis,” she said.
“KG Hospital has been supplying blood to about 30 centres but all or most of them want only whole blood and not the component(s). It is because the practice still remains strong,” she said.
Dr Priyadharshni stated that only fresh blood would have functional platelets and the whole blood would not contain platelets. Platelets were prone to bacterial contamination, if kept in room temperature. “Platelet transfusion is determined by platelet counts and bleeding time,” she stated.
She emphasized the point that blood transfusion procedure must be monitored by a trained person. Prior to transfusion the blood bag must be checked for any leakage, discolouration, large clots and so on.
Dr Priyadharshni cautioned: “Do not ever warm the blood. Only when there is massive transfusion warm the blood. When the patient has a running temperature do not transfuse blood, unless there is an emergency.”