Blood Transfusion

A 60-year-old man came with his family. It’s heard weeping from one who accompany. Such matter, as long as I know, designate that the condition of patient is worrying. And it is true. That moment, patient is in a weak condition. Patient is seen out of breath which marked by breath frequency which mounting. Besides, patient also vomits several times during journey to hospital. At that moment, blood pressure measured is 100 / 60.

Pursuant to physical examination and laboratory test which I did, patient diagnosed as anaemia. Hb (hemoglobin) at that moment 4,0 g / dL. Patient is planned to get two colf of PRC (packed red cell) transfusion, injection of ampicillin 1 gr / 8 hour and injection of ranitidin 1 ampoule / 12 hour. Next day, PRC transfusion is given 1 colf per day till Hb more than 8,0 g / dL.

Blood Transfusion as Therapy

Blood transfusion is indicated to patient with anaemia, bleeding, coagulation trouble and also thalassemia. Patient with heavy anaemia, if did not be boosted up as soon as possible, can cause two matters. First, can continue to heart failure, because of heart activities is mounting. Second, can continue to hipoksia, because cell oxygenation decreasing.

One unit of PRC can give increase of Hb equal to 0,25-0,5 g / dL. In a normovolemia condition, one unit given in 1-3 hour, and don't longer than 5 hours, in order not to give challenge germ to grow up during blood stay in room temperature.

At chronic anaemia, where body fluid did not decrease drastically, this cell oxygenation still can be defended by heart, by improving cardiac output. This matter as according to formula of Nunn-Freeman, where Available O2 = CO {( Hb X Sao2 x 1.34 + ( x pO2 0.003)}. CO is cardiac output and of Hb is haemoglobin.

Transfusion require to be given when Hb less than 8,0 and there is sign of lack of oxygen. There are two kinds of blood type: whoole blood (WB) and of packed red cell (PRC). WB is given if anaemia accompanied by hipovolemia and also trombositopenia. But, if the target is just for improving Hb, PRC is best choice.