How does blood transfusion affect? Regular donation is addictive. Donation is bad for your appearance

Blood transfusions for low hemoglobin are prescribed only in emergency cases, when its level drops beyond the critical phase, namely less than 60 g/l. Thanks to these measures, not only iron levels rapidly increase, but also overall health improves significantly. Despite the expressed positive action from the procedure, the consequences of blood transfusion with low hemoglobin are not always predictable.

How does a blood transfusion occur to restore hemoglobin?

The process of blood transfusion with reduced hemoglobin readings is called blood transfusion in medical terminology. It is carried out only in a hospital setting and under close supervision. medical personnel. Blood is transfused to increase iron levels from a healthy donor to a recipient. The procedure is possible only if the blood type and Rh factor match.

Sequence of mandatory actions during blood transfusion:

• The doctor finds out whether there are good reasons for blood transfusion, and whether there are any contraindications. In this case, collecting an anamnesis is mandatory; it is necessary to find out from the patient: whether a blood transfusion medium has previously been transfused to increase hemoglobin, whether allergic reactions have occurred or side effects, the presence of chronic diseases and other individual characteristics of the body that must be taken into account.
• After laboratory research personal blood parameters of the patient, such as group and Rh factor. Additional confirmation of the initial data will be required on site, that is, in the hospital. To do this, a repeat analysis is carried out in a medical institution, and the indicator is compared with the laboratory one - the data must completely match.
• Select the most appropriate donor red blood cell mass for blood transfusion with low hemoglobin. If there is even the slightest discrepancy in even one indicator, blood transfusion to increase hemoglobin is not permitted. The doctor must make sure that the packaging is sealed, and that the passport contains all the information regarding the number and date of the preparation, the name of the donor, his group and rhesus, the name of the organization of the preparation, the expiration date and the doctor’s signature. The storage duration of donor hematotransfusion composition varies from 20 to 30 days. But even with full compliance with all indicators with visual inspection, the specialist should not find any foreign clots or films in it. After a thorough quality check, a repeat analysis is carried out to confirm the group and rhesus.
• Compatibility is checked using the AB0 system, in which the donor’s blood is combined with the recipient’s blood on a special glass.
• To check the compatibility of the Rh factor, two parts of the patient’s serum mass, one part of the donor’s blood, part of the polyglucin, 5 milliliters of saline are added to a special test tube and the reaction is observed while rotating.
• After studying the compatibility data, a biological test is carried out by injecting 25 milliliters into the recipient donated blood. It is administered three times with an interval of three minutes between injections. At this time, the patient is closely monitored; if the heartbeat and pulse are normal, the face has no signs of redness and general health is stable, then the plasma is allowed for transfusion.
• Blood is not used in its original form; its various components are transfused depending on the intended purpose. If hemoglobin is low, packed red blood cells are transfused. This component of the blood flow is administered by drip at a rate of 40–60 drops per minute. The patient must constantly be under the supervision of a doctor who monitors his general health, pulse, pressure, temperature, condition skin, followed by entering the information into the medical record.
• At the end of the process, the patient needs rest for two hours. He remains under doctor's supervision for another day, then has his blood and urine tested.
• After the transfusion is completed, approximately 15 milliliters of the recipient's blood serum and the donor's red blood cells are left. They are stored in the refrigerator for about 2 days, if there is a need to do an analysis, in case of complications.

Blood transfusion for anemia is not allowed for everyone, with the exception of people with a rare blood type. Restoration of hemoglobin in them can be carried out only with the use of iron-containing drugs and a special diet, including foods rich in iron.

Possible consequences of blood transfusion to raise hemoglobin

Before placing a drip in the recipient, a series of compatibility tests are carried out to avoid clumping (agglutination) of red blood cells, which can lead to death. Despite compliance with preliminary safety measures when performing blood transfusions with reduced hemoglobin, it is not always possible to avoid unforeseen consequences.

Types of complications during blood transfusion to increase hemoglobin:

• Jet:
  • increase in body temperature;
  • massive blood transfusion syndrome, which may be associated with a larger than necessary volume of administered blood;
  • hemolytic shock can develop due to antigenic incompatibility of the blood; in this situation, the membranes of red blood cells disintegrate, which leads to poisoning of the body with metabolic products;
  • citrate shock can only manifest itself if canned blood is used during transfusion, due to the use of citrate salt as a preservative;
  • post-transfusion shock is caused by the consequences of transfusion of “bad” blood in an overheated state, contaminated with toxins, with an admixture of decayed blood cells;
  • anaphylactic shock may occur due to an allergy to the administered blood transfusion medium.

A blood-contact infection is possible when an emergency blood transfusion is necessary due to a sharp decrease in hemoglobin and there is no time to withstand it. It is mandatory that the blood transfusion medium is carefully monitored for the presence of microorganisms. To do this, it is kept for six months and re-examined.

Symptoms of reduced hemoglobin

It is easy to determine the level of iron in the blood; all you need to do is take a blood test at a local clinic or diagnostic laboratory. The reason for taking the test may be an examination related to a visit to the doctor or the presence of obvious signs indicating anemia. Based on the results of the study, it will become clear which measures to restore iron in the body to prefer - iron-containing nutrition and medications or blood transfusion to increase hemoglobin.

The most common symptoms of anemia include:

• Palpitations and difficulty breathing.
• Fainting and dizziness.
• Pain in the head, sensation of tinnitus.
• Feeling of weakness and pain in the muscular system.
• Changes in taste and smell.
• Changes in the structure of nails.
• Thinning, dry hair.
• Paleness and dryness of mucous membranes and skin.
• Prolonged lethargy, apathy, fatigue, depression.
• Low blood pressure, abnormalities in the operation of the VGT system, cold lower extremities.

If the quantitative value of iron has not decreased much, then a person may not even be aware of it. Or he begins to worry about an ongoing feeling of fatigue, even after good sleep, although anemia is often accompanied by insomnia.

Such sensations are caused by oxygen starvation of the body due to a lack of iron-containing protein in red blood cells in the blood or a decrease in their number or volume. After all, as you know, it is the red blood cells that are entrusted with one of the most important missions of supplying all organs, systems and tissues of the body with oxygen and the subsequent removal of carbon dioxide. Therefore, if there is a significant deviation from the norm in the hemoglobin level, it may be necessary to resort to blood transfusion to increase it.

Blood transfusion for insufficient hemoglobin in childhood

If you find one or more symptoms of reduced hemoglobin in yourself or your loved ones, you should contact the clinic for a study of the composition of the blood flow.

Particular attention should be paid to maintaining iron in the blood of children at the proper level.

The child is unlikely to be able to clearly explain what is happening to him. Namely in childhood disruption of oxygen metabolism is the most dangerous because it can lead to physical or mental retardation.

It is not uncommon for the need for transfusion to increase hemoglobin or eliminate the consequences of anemia in newborns and, especially in premature infants. It should be borne in mind that prematurity always entails an insufficient hemoglobin level, but in the absence of severe anemia, the iron level is completely restored on its own by the first year of life. In case of a vital need for blood transfusion with low hemoglobin, careful selection of donor blood will be required, since maternal similar situation use is prohibited.

A newborn may need a blood transfusion due to hemoglobin in case of hemolytic anemia - this is when the blood of the mother and child is incompatible.

Hematological anemia has a number of serious consequences:

• Not the possibility of bearing a fetus.
• Birth of a baby with edema.
• The appearance of severe jaundice.

If a severe form of anemia is detected in a timely manner in the fetus during pregnancy, it is given an intrauterine transfusion of red blood cells. The procedure, in addition to following standard measures for selecting donor blood, testing for susceptibility and compatibility, is carried out using ultrasound.

A normal level of hemoglobin is necessary for all human life processes, the full formation of the body, and maintaining health. The level of iron in the bloodstream is one of the most important for healthy well-being. To maintain it normally, you only need to eat well and devote as much time as possible to walks in the fresh air.

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Blood transfusion is already a common thing for modern man. In the event of any incident where a person has significant blood loss, this is actually the only chance for salvation. But what do we really know about blood? Recently I came across a story about how a man, after a blood transfusion, discovered new abilities in himself and began to paint. But how could this happen? Let's try to find the answer to this question together...

Let's start, as always, with a short excursion into history. The magical effect of blood has always been recognized. In fact, in all rituals it was an integral component of the ritual. At one time, even Cleopatra took baths from the blood of young slaves. She believed that this would rejuvenate her. And it is worth noting that she was not so far from the truth! Modern scientist Thomas Rando from Stanford University (California) was convinced of this himself.

He conducted such an experiment. He took an old mouse and transfused it with young blood. And what do you think? the mouse has rejuvenated! Of course, this does not mean that you can live forever with a blood transfusion, but after the procedure, the experimental mouse had completely regenerated liver tissue and returned to its former muscle elasticity. According to Rando, “young blood activated the “restorative” mechanism of cells, which over the years fell into a “dormant state.” Afterwards, a virtually identical experiment was conducted by researchers from Harvard, who also obtained virtually identical results.

And then, by the way, a reverse experiment was conducted on blood transfusions into younger mice from older ones. And the result was just the opposite. What does this experiment say? I think the conclusions are obvious.

An experiment was also carried out with cockroaches. Blood plasma was taken from one who was oriented in a certain area and transfused to another, who was in this area for the first time. The latter from that moment began to navigate without problems.

But after the revolution, the world's first scientific-practical one was created in Moscow. Where another, no less interesting experiment was carried out. A group of volunteers received a complete blood transfusion. Among the volunteers was the son of Alexander Bogdanov (the founder of the institute), Alexander Malinovsky. He participated in his father's experiment at the age of 25. His own blood was replaced with that of a forty-year-old athlete. Soon the constitution of Malinovsky, who was frail from birth, began to change. He became a powerful, big-boned man. It became obvious that blood carries a much greater charge of information than was commonly believed.

In the end, it is worth noting that some anthropologists generally believe that dividing humanity into races is too simple. Like, blood type is much more important indicator individuality than race. In fact, an African and an Indo-European with group A (II) can exchange organs or blood, have the same habits, digestive functions and immune structures. But for an African with group A (II) and an African with group B (III), for example, such coincidences are very rare.

Do you agree with this opinion? Tell us about it in the comments.

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In the 20th century, scientists began to better understand how complex a substance blood is. They learned that there are different blood types. And for transfusion, it is very important that the donor’s blood matches the patient’s blood. If a person with type A is given type B blood, an acute hemolytic reaction will occur. This will lead to the destruction of a large number of red blood cells, as a result of which the person will soon die. Although today one can never do without determining the blood group and cross-testing, mistakes still happen. Every year people die due to hemolytic reactions.

Facts show that the issue of compatibility is not limited to the few blood groups that doctors are trying to select. Why? In the article "Blood Transfusion: Uses, Abuses, and Hazards" Dr. Douglas Pasi the Younger writes: “30 years ago, Sampson called blood transfusion sufficient dangerous procedure..." Since that time, at least 400 more erythrocyte antigens have been discovered and described.

Today, scientists are studying the effect of transfused blood on protective forces a person, in other words, on immunity. What might this mean for you or a relative who needs surgery?

During a heart, liver, or other organ transplant, the patient's immune system can recognize foreign tissue and reject it. And a blood transfusion is, in fact, a tissue transplant. Therefore, even “correctly” selected blood can suppress the immune system. At one meeting of pathologists, it was noted that blood transfusions are directly related to immunological reactions (Medical World News).

One of the main tasks immune system- identify and destroy malignant cancer cells. Will suppression of the immune system provoke cancer and subsequently lead to death? Let's look at two messages.

The journal Cancer reported the results of a study conducted in the Netherlands: “It was observed that blood transfusions have a very negative effect on life expectancy after surgery in patients with colon cancer. Among those in this group who received a transfusion, the proportion of patients who survived 5 years was 48 percent, and those who did not receive a transfusion was 74 percent.”

Doctors from the University of Southern California observed hundreds of cancer patients undergoing surgery. For all laryngeal cancers, the recurrence rate was 14 percent among those who did not receive blood and 65 percent among those who did receive it. What about cancer? oral cavity, pharynx and nose or sinuses, where relapse occurred in 31 percent of people who did not receive blood transfusions and in 71 percent of people who did receive blood transfusions. John Sprite, in his article “Blood Transfusions and Cancer Surgery,” noted: “Perhaps cancer surgeons should stop using blood altogether.”

Another important task of the immune system is to protect the body from different infections. Therefore, it is not surprising why some studies show that patients who receive blood are more vulnerable to infections. Dr. Tartter researched colon surgery. Among the patients who received a transfusion, 25 percent of people were infected, and among those who did not receive a transfusion, only 4 percent were infected. Tartter notes: “Blood transfusions that were given during or after surgery were accompanied by infectious complications… «.

The risk of postoperative infection increases as the number of units of blood transfused increases. In 2012, meeting participants American Association Blood and plasma storage facilities determined that among patients who received donor blood during hip replacement, 23 percent of people were infected, and among those who did not receive blood, there were no cases of infection at all.

Speaking about these consequences of blood infusion, John Collins wrote: “It would be a real irony if it turned out that a “treatment” that does little to help in any case also complicates one of the greatest problems of these patients.”

All materials on the site were prepared by specialists in the field of surgery, anatomy and related disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

Many people take blood transfusions quite lightly. It would seem that there could be any danger in taking the blood of a healthy person that matches the blood group and other indicators and transfusing it to a patient? Meanwhile, this procedure is not as simple as it might seem. Nowadays, it is also accompanied by a number of complications and adverse consequences, and therefore requires increased attention from the doctor.

The first attempts to transfuse blood to a patient were made back in the 17th century, but only two managed to survive. The knowledge and development of medicine in the Middle Ages did not make it possible to select blood suitable for transfusion, which inevitably led to the death of people.

Attempts to transfuse someone else's blood have become successful only since the beginning of the last century thanks to the discovery of blood groups and the Rh factor, which determine the compatibility of the donor and recipient. The practice of administering whole blood has now been practically abandoned in favor of transfusion of its individual components, which is safer and more effective.

The first blood transfusion institute was organized in Moscow in 1926. Transfusion service today is the most important unit in medicine. In the work of oncologists, oncohematologists, and surgeons, blood transfusion is an integral component of the treatment of seriously ill patients.

The success of blood transfusion is entirely determined by the careful assessment of indications and the sequence of implementation of all stages by a specialist in the field of transfusiology. Modern medicine has made blood transfusion the safest and most common procedure possible, but complications still occur, and death is no exception to the rule.

The cause of errors and negative consequences For the recipient, a low level of knowledge in the field of transfusiology on the part of the doctor, violation of the surgical technique, incorrect assessment of indications and risks, erroneous determination of group and Rh affiliation, as well as individual compatibility of the patient and the donor for a number of antigens may occur.

It is clear that any operation carries a risk that does not depend on the qualifications of the doctor, force majeure circumstances in medicine have not been canceled, but, nevertheless, the personnel involved in the transfusion, starting from the moment of determining the donor’s blood type and ending with the infusion itself, must be very approach each of your actions responsibly, avoiding a superficial attitude to work, haste and, especially, a lack of sufficient knowledge even in the seemingly most insignificant aspects of transfusiology.

Indications and contraindications for blood transfusion

To many people, a blood transfusion resembles a simple infusion, just as it happens when administering saline or medications. Meanwhile, blood transfusion is, without exaggeration, a transplantation of living tissue containing many heterogeneous cellular elements carrying foreign antigens, free proteins and other molecules. No matter how well the donor’s blood is selected, it will still not be identical for the recipient, so there is always a risk, and the doctor’s first priority is to make sure that a transfusion is not necessary.

When determining indications for blood transfusion, a specialist must be sure that other treatment methods have exhausted their effectiveness. When there is even the slightest doubt that the procedure will be useful, it should be abandoned completely.

The goals pursued during transfusion are to replenish lost blood during bleeding or to increase coagulation due to donor factors and proteins.

The absolute indications are:

1. Severe acute blood loss;
2. Shock conditions;
3. Bleeding that doesn't stop;
4. Severe anemia;
5. Planning surgical interventions, accompanied by blood loss, and also requiring the use of equipment for artificial circulation.

Relative indications The procedure may lead to anemia, poisoning, hematological diseases, and sepsis.

Establishment contraindications - the most important stage in planning blood transfusion, on which the success of treatment and consequences depend. Obstacles are considered:

• Decompensated heart failure (with inflammation of the myocardium, coronary disease, vices, etc.);
• Bacterial endocarditis;
• Arterial hypertension of the third stage;
• Strokes;
• Thromboembolic syndrome;
• Pulmonary edema;
• Acute glomerulonephritis;
• Severe liver and kidney failure;
• Allergies;
• Generalized amyloidosis;
• Bronchial asthma.

The physician planning a blood transfusion should obtain detailed information about allergies from the patient, whether transfusions of blood or its components were previously prescribed, how you felt after them. In accordance with these circumstances, a group of recipients with elevated transfusiological risk. Among them:

1. Persons with previous transfusions, especially if they occurred with adverse reactions;
2. Women with a burdened obstetric history, miscarriages, who gave birth to infants with hemolytic jaundice;
3. Patients suffering from cancer with tumor disintegration, chronic suppurative diseases, pathology of the hematopoietic system.

If there are adverse consequences from previous transfusions or a burdened obstetric history, one can think about sensitization to the Rh factor, when the potential recipient has circulating antibodies that attack “Rh” proteins, which can lead to massive hemolysis (destruction of red blood cells).

When identifying absolute readings, when administering blood is tantamount to preserving life, some contraindications have to be sacrificed. In this case, it is more correct to use individual blood components (for example, washed red blood cells), and it is also necessary to ensure measures to prevent complications.

If you are prone to allergies, desensitizing therapy is carried out before blood transfusion (calcium chloride, antihistamines- pipolfen, suprastin, corticosteroid hormones). Risk of retaliation allergic reaction for someone else’s blood is less if its quantity is as small as possible, the composition will contain only the components missing for the patient, and the volume of fluid will be replenished with blood substitutes. Before planned operations, collecting your own blood may be recommended.

Preparation for blood transfusion and procedure technique

Blood transfusion is an operation, although not typical in the minds of the average person, because it does not involve incisions and anesthesia. The procedure is carried out only in a hospital, because there is the possibility of providing emergency care And resuscitation measures with the development of complications.

Before the planned blood transfusion, the patient is carefully examined for pathology of the heart and blood vessels, kidney and liver function, and the state of the respiratory system to exclude possible contraindications. Blood group and Rh status must be determined, even if the patient knows them for sure or they have already been determined somewhere before. The price of a mistake can be life, so clarifying these parameters again - required condition transfusion.

A couple of days before the blood transfusion is carried out general analysis blood, and before it the patient should cleanse the intestines and bladder. The procedure is usually prescribed in the morning before meals or after a light breakfast. The operation itself is not big technical complexity. To carry it out, the saphenous veins of the arms are punctured; for long transfusions, large veins (jugular, subclavian) are used, in emergency situations- arteries, where other fluids are also injected, replenishing the volume of contents in the vascular bed. All preparatory measures, starting from establishing the blood type, the suitability of the transfused liquid, calculating its quantity, composition - one of the most critical stages of transfusion.

Based on the nature of the goal being pursued, the following are distinguished:

• Intravenous (intraarterial, intraosseous) administration transfusion media;
• Exchange transfusion- in case of intoxication, destruction of red blood cells (hemolysis), acute renal failure they replace part of the victim’s blood with donor blood;
• Autohemotransfusion- infusion of one’s own blood, removed during bleeding, from cavities, and then purified and preserved. It is advisable for a rare group, difficulties with donor selection, or previous transfusion complications.

blood transfusion procedure

For blood transfusions, disposable plastic systems with special filters are used to prevent the penetration of blood clots into the recipient's vessels. If the blood was stored in a polymer bag, then it will be poured from it using a disposable dropper.

The contents of the container are carefully mixed, a clamp is applied to the outlet tube and cut off, having previously been treated with an antiseptic solution. Then connect the bag tube to the drip system, fix the blood container vertically and fill the system, making sure that no air bubbles form in it. When blood appears at the tip of the needle, it will be taken to control the group and compatibility.

After puncturing the vein or connecting the venous catheter to the end of the drip system, the actual transfusion begins, which requires careful monitoring of the patient. First, approximately 20 ml of the drug is administered, then the procedure is suspended for a few minutes to exclude an individual reaction to the injected mixture.

Alarming symptoms indicating intolerance to the blood of the donor and recipient in terms of antigenic composition will be shortness of breath, tachycardia, redness of the facial skin, and decreased blood pressure. When they appear, the blood transfusion is immediately stopped and the patient is given the necessary medical care.

If similar symptoms does not occur, the test is repeated two more times to ensure that there is no incompatibility. When wellness the recipient of the transfusion can be considered safe.

The rate of blood transfusion depends on the indications. Both drip administration at a rate of about 60 drops every minute and jet administration are allowed. During blood transfusion, the needle may become clotted. Under no circumstances should a clot be pushed into the patient’s vein; the procedure should be stopped, the needle removed from the vessel, replaced with a new one, and another vein punctured, after which blood injection can be continued.

When almost all the donor blood has reached the recipient, a small amount is left in the container, which is stored for two days in the refrigerator. If during this time the recipient develops any complications, the left drug will be used to clarify their cause.

All information about the transfusion must be recorded in the medical history - the amount of liquid used, the composition of the drug, the date, time of the procedure, the result of compatibility tests, the patient’s well-being. Information about the blood transfusion drug is on the label of the container, so most often these labels are pasted into the medical history, specifying the date, time and well-being of the recipient.

After the operation, you are required to remain in bed for several hours; your body temperature is monitored every hour for the first 4 hours and your pulse is determined. The next day, general blood and urine tests are taken.

Any deviation in the recipient’s well-being may indicate post-transfusion reactions, Therefore, the staff carefully monitors the complaints, behavior and appearance of patients. When the pulse accelerates, sudden hypotension, pain in chest, fever is highly likely negative reaction for transfusion or complications. Normal temperature in the first four hours of observation after the procedure - evidence that the manipulation was performed successfully and without complications.

Transfusion media and drugs

For administration as transfusion media the following can be used:

1. Whole blood - very rare;
2. Frozen red blood cells and EMOLT (erythrocyte mass depleted of leukocytes and platelets);
3. Leukocyte mass;
4. Platelet mass (stored for three days, requires careful selection of a donor, preferably based on HLA antigens);
5. Fresh frozen and medicinal types plasma (anti-staphylococcal, anti-burn, anti-tetanus);
6. Preparations of individual coagulation factors and proteins (albumin, cryoprecipitate, fibrinostat).

It is not advisable to administer whole blood due to its high consumption and high risk transfusion reactions. In addition, when a patient needs a strictly defined blood component, there is no point in “loading” him with additional foreign cells and fluid volume.

If a person suffering from hemophilia needs the missing coagulation factor VIII, then to obtain the required amount it will be necessary to administer not one liter of whole blood, but a concentrated preparation of the factor - this is only a few milliliters of liquid. To replenish fibrinogen protein, even more whole blood is required - about ten liters, but ready-made protein preparation contains the required 10-12 grams per minimum volume liquids.

In case of anemia, the patient needs, first of all, red blood cells; in case of coagulation disorders, hemophilia, thrombocytopenia - individual factors, platelets, proteins, therefore it is more effective and correct to use concentrated preparations of individual cells, proteins, plasma, etc.

It is not just the amount of whole blood that a recipient may unreasonably receive that plays a role. A much greater risk is posed by numerous antigenic components that can cause a severe reaction upon first administration, repeated transfusion, or pregnancy even after a long period of time. It is this circumstance that forces transfusiologists to abandon whole blood in favor of its components.

It is allowed to use whole blood during interventions on open heart in conditions of extracorporeal circulation, in emergency cases with severe blood loss and shocks, during exchange transfusions.

compatibility of blood groups during transfusion

For blood transfusions, single-group blood is taken that matches the Rh group with those of its recipient. IN exceptional cases you can use group I in a volume not exceeding half a liter, or 1 liter of washed red blood cells. In emergency situations, when there is no suitable blood group, a patient with group IV can be given any other with a suitable Rh (universal recipient).

Before the start of blood transfusion, the suitability of the drug for administration to the recipient is always determined - the period and compliance with storage conditions, the tightness of the container, the appearance of the liquid. In the presence of flakes, additional impurities, hemolysis, films on the surface of the plasma, blood clots, the drug should not be used. At the beginning of the operation, the specialist is obliged to once again check the match of the group and Rh factor of both participants in the procedure, especially if it is known that the recipient has had adverse consequences from transfusion, miscarriages or Rh-conflict during pregnancy in women.

Complications after blood transfusion

In general, blood transfusion is considered safe procedure, but only when the technique and sequence of actions are not violated, the indications are clearly defined and the correct transfusion medium is selected. If there are errors at any stage of blood transfusion therapy, individual characteristics the recipient may experience post-transfusion reactions and complications.

Violation of the manipulation technique can lead to embolism and thrombosis. The entry of air into the lumen of the vessels is fraught with air embolism with symptoms of respiratory failure, cyanosis of the skin, chest pain, and a drop in pressure, which requires resuscitation measures.

Thromboembolism can be a consequence of both the formation of clots in the transfused fluid and thrombosis at the site of drug administration. Small blood clots are usually destroyed, while large ones can lead to thromboembolism of the branches of the pulmonary artery. Massive thromboembolism of pulmonary vessels is deadly and requires immediate medical attention, preferably in intensive care.

Post-transfusion reactions- a natural consequence of the introduction of foreign tissue. They rarely pose a threat to life and can result in an allergy to the components of the transfused drug or in pyrogenic reactions.

Post-transfusion reactions are manifested by fever, weakness, itching of the skin, headaches, and swelling are possible. Pyrogenic reactions account for almost half of all the consequences of transfusion and are associated with the entry of decaying proteins and cells into the recipient’s bloodstream. They are accompanied by fever, muscle pain, chills, bluish skin, and increased heart rate. Allergies are usually observed with repeated blood transfusions and require the use of antihistamines.

Post-transfusion complications can be quite severe and even fatal. The most dangerous complication is the entry into the recipient’s bloodstream of blood incompatible by group and Rh. In this case, hemolysis (destruction) of red blood cells and shock with symptoms of failure of many organs - kidneys, liver, brain, heart - are inevitable.

The main causes of transfusion shock are considered to be physician errors when determining compatibility or violation of blood transfusion rules, which once again indicates the need for increased attention of personnel at all stages of preparation and conduct of the transfusion operation.

Signs blood transfusion shock may appear immediately, at the beginning of the administration of blood products, or several hours after the procedure. Its symptoms are pallor and cyanosis, severe tachycardia against the background of hypotension, anxiety, chills, and abdominal pain. Cases of shock require emergency medical attention.

Bacterial complications and infection (HIV, hepatitis) are very rare, although they are not completely excluded. The risk of contracting an infection is minimal due to the quarantine storage of transfusion media for six months, as well as careful monitoring of its sterility at all stages of procurement.

Among the rarer complications are massive blood transfusion syndrome with the introduction of 2-3 liters in a short period of time. The ingestion of a significant volume of foreign blood may result in nitrate or citrate intoxication, an increase in potassium in the blood, which can lead to arrhythmias. If blood from multiple donors is used, then incompatibility with the development of homologous blood syndrome cannot be ruled out.

To avoid negative consequences, it is important to follow the technique and all stages of the operation, and also strive to use as little blood as possible and its preparations. When the minimum value of one or another impaired indicator is reached, one should proceed to replenishing the blood volume using colloid and crystalloid solutions, which is also effective, but safer.

Video: blood groups and blood transfusion

In medicine, blood transfusion is called blood transfusion. During this procedure, the patient is injected with blood or its components obtained from a donor or from the patient himself. This method is used today to treat many diseases and to save the lives of people in various pathological conditions.

People tried to transfuse the blood of healthy people to the sick back in ancient times. At that time there were few successful blood transfusions; more often such experiments ended tragically. Only in the twentieth century, when blood groups were discovered (in 1901) and the Rh factor (in 1940), were doctors able to avoid deaths due to incompatibility. Since then, transfusion has not become as dangerous as before. The method of indirect blood transfusion was mastered after they learned how to store the material for future use. For this, sodium citrate was used, which prevented coagulation. This property of sodium citrate was discovered at the beginning of the last century.

Today, transfusiology has become an independent science and medical specialty.

There are several methods of blood transfusion:

Several routes of administration are used:

• into the veins - the most common method;
• into the aorta;
• into an artery;
• V Bone marrow.

The most commonly used method is the indirect method. Whole blood is used extremely rarely today, mainly its components: fresh frozen plasma, erythrocyte suspension, erythrocyte and leukocyte mass, platelet concentrate. In this case, a disposable blood transfusion system is used to administer the biomaterial, to which a container or bottle with a transfusion medium is connected.

Direct transfusion is rarely used - directly from the donor to the patient. This type of blood transfusion has a number of indications, including:

• prolonged bleeding in hemophilia that cannot be treated;
• lack of effect from indirect transfusion with in a state of shock 3 degrees with blood loss of 30-50% of blood;
• disturbances in the hemostatic system.

This procedure is carried out using a device and a syringe. The donor is examined at the transfusion station. Immediately before the procedure, the group and Rh of both participants are determined. Tests are being carried out for individual compatibility and bioassays. During direct transfusion, up to 40 syringes (20 ml) are used. Blood transfusion follows the following scheme: a nurse takes blood from a vein from a donor and hands the syringe to the doctor. While he is injecting the material into the patient, the nurse is drawing the next portion and so on. To prevent clotting, the first three syringes are filled with sodium citrate.

During autohemotransfusion, the patient is transfused with his own material, which is taken during the operation immediately before the procedure or in advance. The advantage of this method is the absence of complications during blood transfusion. The main indications for autotransfusion are the inability to select a donor, rare group, risk severe complications. There are also contraindications - final stages malignant pathologies, serious illnesses kidneys and liver, inflammatory processes.

There are absolute and specific indications for blood transfusion. The absolute ones include the following:

• Acute blood loss - more than 30% within two hours. This is the most common indication.
• Surgery.
• Continuous bleeding.
• Severe anemia.
• State of shock.

For transfusion, in most cases, it is not whole blood that is used, but its components, such as plasma.

Among the specific indications for blood transfusion are the following:

1. Hemolytic diseases.
2. Anemia.
3. Severe toxicosis.
4. Purulent-septic processes.
5. Acute intoxication.

Practice has shown that blood transfusion is a very responsible tissue transplant operation with possible tissue rejection and subsequent complications. There is always a risk of violation important processes in the body due to blood transfusion, so it is not indicated for everyone. If a patient requires such a procedure, doctors are required to consider contraindications to blood transfusion, which include the following diseases:

• hypertension Stage III;
• heart failure caused by cardiosclerosis, heart defects, myocarditis;
• purulent inflammatory processes in the inner lining of the heart;
• circulatory disorders in the brain;
• allergies;
• protein metabolism disorder.

Disposable systems are used for transfusion

In cases of absolute indications for blood transfusion and the presence of contraindications, transfusion is carried out with preventive measures. For example, they use the blood of the patient himself for allergies.

There is a risk of complications after blood transfusion in the following categories of patients:

• women who have suffered miscarriages, difficult births, or given birth to children with jaundice;
• people from malignant tumors;
• patients who have had complications with previous transfusions;
• patients with long-term septic processes.

Preparation, separation into components, preservation and preparation of drugs are carried out in special departments and at blood transfusion stations. There are several sources of blood, including:

1. Donor. This is the most important source of biomaterial. Any healthy person can become one on a voluntary basis. Donors pass mandatory check, in which they are examined for hepatitis, syphilis, and HIV.
2. Waste blood. Most often it is obtained from the placenta, namely, it is collected from women in labor immediately after childbirth and ligation of the umbilical cord. It is collected in separate vessels containing a preservative. Drugs are prepared from it: thrombin, protein, fibrinogen, etc. One placenta can produce about 200 ml.
3. Corpse blood. They take from healthy people who died suddenly as a result of an accident. The cause of death may be lesions electric shock, closed injuries, cerebral hemorrhages, heart attacks and more. Blood is drawn no later than six hours after death. The blood that flows out on its own is collected in containers, adhering to all the rules of asepsis, and used for the preparation of drugs. This way you can get up to 4 liters. At the stations where the preparation is carried out, it is checked for group, rhesus, and the presence of infections.
4. Recipient. This is a very important source. On the eve of the operation, blood is taken from the patient, preserved and transfused. It is permissible to use blood that has spilled into the abdominal or pleural cavity during illness or injury. In this case, you don’t have to check it for compatibility; it happens less often various reactions and complications, transfusion is less dangerous.

The main blood transfusion media include the following.

For the preparation, special solutions are used, which includes the preservative itself (for example, sucrose, dextrose, etc.); a stabilizer (usually sodium citrate), which prevents blood clotting and binds calcium ions; antibiotics. The preservative solution is present in the blood in a ratio of 1 to 4. Depending on the type of preservative, the product can be stored for up to 36 days. At various indications use material different terms storage For example, in case of acute blood loss, medium with short shelf life (3-5 days) is used.

Transfusion media are kept in sealed containers

Sodium citrate (6%) is added to it as a stabilizer (ratio with blood 1 to 10). This medium should be used within a few hours of preparation.

It is stored for no more than a day and is used in artificial blood circulation machines. Sodium heparin is used as a stabilizer, dextrose as a preservative.

Today, whole blood is practically not used due to possible reactions and complications that are associated with numerous antigenic factors that are found in it. Component transfusions provide greater healing effect because they act purposefully. Red blood cells are transfused for bleeding and anemia. Platelets – for thrombocytopenia. Leukocytes – for immunodeficiency, leukopenia. Plasma, protein, albumin - for hemostasis disorders, hypodysproteinemia. An important advantage of transfusing components is that more effective treatment at lower costs. The following blood components are used for blood transfusion:

• erythrocyte suspension - preservative solution with erythrocyte mass (1:1);
• erythrocyte mass - 65% of plasma is removed from whole blood by centrifugation or sedimentation;
• frozen red blood cells obtained by centrifugation and washing of blood with solutions in order to remove plasma proteins, leukocytes, and platelets from it;
• leukocyte mass obtained by centrifugation and settling (represents a medium consisting of white cells in high concentration with an admixture of platelets, erythrocytes and plasma);
• platelet mass obtained by light centrifugation from canned blood, which has been stored for no more than a day, use freshly prepared mass;
• liquid plasma – contains bioactive components and proteins, is obtained by centrifugation and settling, used within 2-3 hours after preparation;
• dry plasma - obtained by vacuum from frozen;
• albumin - obtained by dividing plasma into fractions, released in solutions of different concentrations (5%, 10%, 20%);
• protein - consists of 75% albumin and 25% alpha and beta globulins.

Before the procedure, blood compatibility tests between the donor and recipient are required.

During blood transfusion, the doctor must adhere to a certain algorithm, which consists of the following points:

1. Determination of indications, identification of contraindications. In addition, the doctor asks the recipient whether he knows what group and Rh factor he has, whether there have been blood transfusions in the past, and whether there have been any complications. Women receive information about existing pregnancies and their complications (for example, Rh conflict).
2. Determination of the patient's group and Rh factor.
3. They choose which blood is suitable according to the group and Rhesus, and determine its suitability, for which a macroscopic assessment is made. It is carried out on the following points: correctness, tightness of packaging, expiration date, external compliance. Blood should have three layers: upper yellow (plasma), middle gray (leukocytes), lower red (erythrocytes). Plasma cannot contain flakes, clots, or films; it must only be transparent and not red.
4. Testing of donor blood using the AB0 system from a bottle.
5. Tests for individual compatibility in groups are required during blood transfusion at a temperature of 15°C to 25°C. How and why do they do it? To do this to the surface white Place a large drop of the patient's serum and a small drop of donor blood and mix them. The assessment takes place in five minutes. If the red blood cells do not stick together, then it is compatible; if agglutination occurs, then the transfusion cannot be done.
6. Rh compatibility tests. This procedure can be carried out in different ways. In practice, a test with 33 percent polyglucin is most often done. Centrifugation is carried out for five minutes in a special tube without heating. Two drops of the patient's serum and a drop of donor blood and polyglucin solution are dropped onto the bottom of the tube. Tilt the test tube and rotate it around its axis so that the mixture is distributed over the walls in an even layer. The rotation continues for five minutes, then add 3 ml of saline solution and mix, without shaking, but tilting the container to a horizontal position. If agglutination occurs, then transfusion is impossible.
7. Carrying out a biological test. To do this, the recipient is injected with 10-15 ml of donor blood and his condition is monitored for three minutes. This is done three times. If the patient feels normal after such a check, the transfusion begins. The appearance of symptoms in the recipient such as shortness of breath, tachycardia, flushing of the face, fever, chills, abdominal and lower back pain indicates that the blood is incompatible. In addition to the classic biotest, there is a hemolysis test, or Baxter's test. In this case, 30-45 ml of donor blood is injected into the patient; after a few minutes, the patient’s blood is drawn from a vein, which is then centrifuged and its color is assessed. Regular color indicates compatibility, red or pink indicates the impossibility of transfusion.
8. Transfusion is carried out by drip. Before the procedure, the bottle with donor blood must be kept at room temperature for 40 minutes, in some cases it is heated to 37°C. A disposable transfusion system equipped with a filter is used. Transfusion is carried out at a rate of 40-60 drops/min. The patient is constantly monitored. Leave 15 ml of medium in the container and store it in the refrigerator for two days. This is done in case an analysis is required due to complications that have arisen.
9. Filling out a medical history. The doctor needs to write down the patient’s and donor’s group and Rh factor, data from each bottle: its number, date of preparation, donor’s last name and his group and Rh factor. The result of the bioassay must be entered and the presence of complications noted. At the end, indicate the name of the doctor and the date of transfusion, and put a signature.
10. Monitoring the recipient after transfusion. After the transfusion, the patient must remain in bed for two hours and be under the supervision of medical personnel for 24 hours. Special attention is given to his well-being in the first three hours after the procedure. His temperature, pressure and pulse are measured, complaints and any changes in health are assessed, urination and urine color are assessed. The next day after the procedure, a general blood and urine test is performed.

Blood transfusion is a very responsible procedure. To avoid complications, careful preparation is necessary. There are certain risks, despite scientific and technological advances. The doctor must strictly adhere to the rules and transfusion regimens and carefully monitor the recipient's condition.

Blood transfusion for oncology: when is it required and how the procedure affects the patient’s condition

Blood transfusion for cancer is a highly effective method of restoring its composition and volume. What are the indications for blood transfusion in oncology, what problems does this procedure help solve and how does it work?

What is blood transfusion and what problems does blood transfusion solve in cancer patients?

Blood transfusion, or blood transfusion, is used quite often for cancer. Blood transfusions help replenish platelets, red blood cells and proteins. Today this procedure is safe for both the donor and the recipient. All donors are required to be tested for HIV, hepatitis and other diseases, so there is no risk to the person receiving the blood transfusion.

For cancer, blood transfusions are most often performed after a course of chemotherapy, although there are other indications for this procedure.

Indications and contraindications for blood transfusion in oncology

In some cases, blood transfusion is necessary for patients undergoing chemotherapy. Sometimes such patients develop anemia - the level of hemoglobin drops seriously, and the person needs to restore it. Typically, a blood transfusion is considered when the hemoglobin level drops to 70 g/dL. In this case, symptoms of anemia such as fast fatiguability, a feeling of lack of air and shortness of breath even with very little exertion, general malaise and drowsiness.

Sometimes anemia in cancer patients develops without chemotherapy - this is the effect of the tumor itself.

Blood transfusion is also vital for such forms of cancer as leukemia. Without regular blood transfusions, the outcome of the disease can be tragic, since with leukemia the bone marrow almost stops producing normal blood cells.

Transfusions are also necessary for internal bleeding, which often accompanies cancer.

Contraindications to blood transfusion are heart failure, pulmonary edema, serious violations cerebral circulation, stage III hypertension, protein metabolism disorders, glomerular nephritis, thromboembolism, liver dysfunction.

When transfusing donor blood and its products, there is also a possible risk of allergy, and this should be taken into account.

The first attempts at blood transfusion were made back in the 17th century, but most of them ended in failure. Blood transfusion began to be used only in the 20th century, when it was discovered that blood has different groups.

Requirements for blood components

Blood contains plasma and three types of cells:

• red blood cells, which are involved in the transport of oxygen;
• platelets that promote wound healing and stop bleeding;
• white blood cells are “soldiers” that fight infections.

As a rule, in case of oncology, it is not whole blood that is transfused, but its components. The choice of substance depends on the indication.

In cases of severe blood loss and decreased hematopoietic function, plasma is usually transfused. For these purposes, plasma is frozen to -45 degrees and thawed just before transfusion - this preserves its properties.

For anemia caused by cancer, a suspension saturated with red blood cells is transfused. This allows you to improve the patient’s condition and prepare him for a course of chemotherapy. After chemotherapy, transfusion of red blood cell suspension is also indicated.

Usually, not one blood transfusion procedure is performed, but several. The duration of the course and the frequency of transfusions depend on the specific indication, as well as the goal that the doctor is trying to achieve.

Typically, infusions are given every 3-4 weeks, but in case of blood loss due to the destruction of tumors, transfusions are required weekly or even more often.

Blood transfusion, despite its apparent simplicity, is a serious manipulation, and it requires preparation.

Before each blood transfusion for cancer patients, the ABO blood group and Rh factor are checked. In addition, the blood of the donor and recipient is tested for compatibility in the laboratory. If the blood is suitable, a small amount is injected into the patient and the reaction is observed for about 15 minutes. In addition, the patient himself is examined: the doctor checks temperature, pulse, breathing and blood pressure.

If everything is in order, the actual transfusion begins. The patient is placed in a special chair, above which a container with a blood product is suspended. It enters the vein through a needle with a catheter or through an infusion port if one is already installed. The blood is transfused slowly, drop by drop, so you have to wait.

Typically, a small amount of blood is transfused in one session. The dose is determined by the doctor, it depends on the problem, the patient’s condition and the drug, but rarely exceeds 300 ml.

The duration of the procedure also depends on the type of blood product and its total volume. For example, transfusion of red blood cells requires 2–4 hours, platelet transfusion is faster - up to 1 hour.

During a blood transfusion, doctors constantly monitor the patient's condition. If an allergy occurs or the condition worsens, the procedure is stopped immediately. The doctor continues to monitor the patient’s well-being even after the blood transfusion.

The blood transfusion procedure is painless, discomfort It is caused only by the insertion of a needle, but many do not feel this manipulation at all.

Blood transfusions are often necessary for cancer patients. Many types of tumors late stages cause serious hematopoietic disorders, which lead to anemia and clotting problems. The situation worsens if the patient undergoes chemotherapy, which also has a bad effect on the blood.

On the other hand, chemotherapy is contraindicated for anemia, but it is still possible to undergo such treatment. If a patient in need of chemotherapy is diagnosed with anemia, a course of blood transfusion is required - blood will be transfused until the levels return to normal. Only then can treatment begin.

Blood transfusion is required after surgery and during tumor disintegration, accompanied by bleeding, to replenish blood loss.

Often, constant transfusions of blood and blood products are required to maintain the life of cancer patients in the later stages of the disease.

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