Against the backdrop of successes in clinical medicine, many methods have been introduced to effectively treat various human pathologies. To date, excellent results have been achieved in transfusiology, that is, the process of transfusion and mixing of blood, its components and substitutes. This section of medical science also studies myelotransplantation, that is, the treatment of hemoblastoses and the correction of bleeding.
Blood transfusion and mixing is quite a serious and complicated procedure. Not so long ago, they resorted to this technique only in extreme cases, since, despite the huge number of indications, there are no less, if not more, contraindications to blood transfusion. To date, this procedure and its features have been studied enough to say that when it is carried out, practically all risks to human life and health are zero.
The basic rules of the procedure
Despite the large number of indications and contraindications for blood transfusion, this procedure was carried out by doctors since ancient times, although often unsuccessfully. But these experiments made it possible to find out that the blood of each person has a Rhesus factor.
In the future, scientists learned to conserve blood components, invented substitutes. A number of rules have also been developed that can minimize risks, in particular:
- blood transfusion must be carried out under sterile conditions;
- regardless of whether a similar technique was previously used, whether the Rhesus factor and other indicators were determined, the attending physician must independently conduct studies, both on the patient and on the donor, for compatibility and diseases;
- the use of any materials that are not tested for viruses of dangerous diseases: AIDS, serum hepatitis and syphilis;
- the received material from the donor cannot be stored for more than 21 days, and then, subject to the temperature regime;
- a single dose of blood taken from a donor cannot exceed 500 milliliters.
The issue of blood transfusion in the perinatal period is always decided individually.
In what cases is the procedure indicated
There are two types of cases where a blood transfusion procedure is necessary: absolute and relative indications. As the name implies, absolute indications are when other treatment is not provided. Relative indications are cases where you can do with other methods of treating the disease.
Absolute readings
The blood transfusion procedure is indicated in the presence of an acute form of anemia, since the presence of such a pathology often leads to death. Anemia can lead to a loss of blood up to 30%, in this case, the level of hemoglobin and blood pressure is significantly reduced. The volume of blood transfusion with low hemoglobin varies from 300 milliliters to 3 liters. In some cases, they pour even more than the highest permitted level. However, in this case, the effect of blood transfusion can be achieved only if the cause of bleeding is completely eliminated.
With surgical or traumatic shock, this procedure is not just shown, but required. In this case, even plasma can be used. Depending on how much blood is lost, the volume of transfusion can reach 1 liter. Along with blood and / or plasma, special medicines are introduced into the patient's body that stimulate overcoming a serious condition.
Severe bleeding (more than 15%) also gives rise to the procedure immediately. The appearance of this condition is possible even with the most severe surgical intervention.
Relative indications
As an auxiliary treatment technique, the blood transfusion procedure is carried out with a strong inflammatory process or the presence of purulent formations. Blood transfusion allows you to stabilize a person’s condition and normalize the immune system. But, under these circumstances, the procedure should be carried out for several days, and the amount of blood injected does not exceed 100 milliliters.
Blood transfusion with low hemoglobin and anemia can be carried out not in an acute form, but as an auxiliary treatment technique.
In the presence of a burn disease, when the patient is in a state of shock, he may be shown this procedure. The volumes in this case are quite large, from 1 to 2 liters. An increased dose is prescribed for intoxication. Instead of blood, freshly frozen plasma can be used. At the septic stage, the amount of transfused blood is reduced to 100-250 milliliters.
If the results of the examinations suggest the possibility of acute blood loss at the time of the operation, then a blood transfusion procedure may be performed in the preoperative period.
DIC is also a relative indicator for using a blood transfusion procedure.
In addition, blood and plasma can be introduced to improve the condition in the presence of some pathologies:
- hepatitis of various forms and types;
- cirrhosis of the liver.
Contraindications
Along with the indications, and contraindications for blood transfusion are divided into absolute and relative. In any circumstances, exacerbation of a number of diseases is a contraindication to the procedure. In this case, the ban is due to the fact that blood transfusion will only exacerbate the existing pathology, which is already in acute form.
Absolute contraindications for blood transfusion:
- myocardial infarction;
- acute form of cardiopulmonary failure, in particular, if pulmonary edema is present.
Under no circumstances should transfusions be performed if AB0 and Rh are not compatible. The presence of immune diseases in the donor or fragile veins is a complete contraindication. It is impossible to take components from a person who has hypertension at stage 3 or has a history of circulatory disorders in the brain, bronchial asthma, or endocarditis.
Relative contraindications for blood transfusion:
- a number of heart diseases;
- rheumatism;
- problems with blood circulation in the brain, especially if the pathology is at the stage of exacerbation;
- tuberculosis;
- thrombosis and embolism;
- kidney and liver problems;
- septic endocarditis.
Additional criteria for assessing the need for a procedure
Of particular importance for determining the need for a transfusion procedure is an allergic history, which the doctor must evaluate before the procedure.
A special assessment requires a situation:
- if blood transfusion was carried out recently, not later than 3 weeks;
- if the woman had problems with bearing the fetus or had a miscarriage;
- suppurative processes that do not pass for a long time;
- decaying malignant neoplasms;
- autoimmune diseases;
- various forms of blood disease.
If at least one of these indicators is present, the patient is at risk and most often the procedure is performed using substitutes.
Compatibility
Very often the question arises: "What blood type can everyone be transfused with?" To date, there are special alignment tables, according to which:
- a person with IV blood group can be infused any other, that is, he is a universal recipient ;
- in the presence of group III, the recipient can be infused with groups I and III;
- if the patient has a blood group II, then donor material of groups I and II is suitable for him.
So which blood type can everyone be transfused with? The first, which is considered universal.
Rhesus factor is of no small importance. Most importantly, if it is Rh +, that is, positive, then a group with a negative Rh factor (Rh-) is suitable for transfusion. It is impossible to carry out the procedure in the reverse order, otherwise the red blood cells will stick together.
Types of transfusion
To date, a number of varieties of transfusion are distinguished:
- intra-arterial administration, that is, through a large artery;
- intravenous injection into the venous sinus or vein;
- intraosseous, that is, into the spongy substance;
- intrauterine, indicated for acute blood loss and the presence of hemolytic disease of the fetus;
- intracardiac.
By the speed of introduction there is a jet and drip technique. The reverse procedure is carried out during the operation, that is, the patient receives his own blood. The exchange technique involves transfusion, partially replacing one's own blood, with the blood of a donor. The term massive blood transfusion involves the introduction of blood in an amount of 30% or more.
The consequences of the procedure
Along with indications and contraindications for blood transfusion, the positive and negative effects of the procedure should be highlighted. In particular, if everything went well, then the patient has a quick recovery of the body, especially when it comes to reduced hemoglobin, intoxication, poisoning and anemia.
The negative consequences include embolic shock, which can occur as a result of a violation of the procedure. If a donor is incorrectly selected, or a specific disease was not detected before transfusion, then the recipient may experience symptoms of the pathology that the donor had.