Transfusion of blood to another person. What is a blood transfusion (hemotransfusion), the rules of conduct, what is the procedure useful and dangerous

Blood transfusion, which replaces the loss of serum and plasma lost in accidents, saves thousands of lives every year.

Determining the blood group in a blood transfusion

Canned blood is delivered to medical institutions, where it is stored in separate rooms at a temperature of 2-6°C. Before a transfusion, the doctor takes a small sample of blood from the patient and sends it to the laboratory for analysis, where they select donor blood that is compatible with the patient's blood type and conduct a cross-test.

First of all, doctors determine the patient's blood type. Ideally, the transfusion requires blood that is similar in type to the patient's, but if this is not available, use a blood group that is compatible with the patient's blood type.

The laboratory assistant who determines the blood group is well aware of the importance of choosing donor blood, the erythrocytes of which will not be attacked by plasma antibodies (plasma is the liquid transparent component of blood in which blood cells are suspended) of the patient.

So, group O (I), characterized by the absence of antigens (substances that provoke immunological reactions) A and B, stimulating the production of antibodies such as anti-A and anti-B, is compatible with all other blood groups, while the blood of group AB, containing these antigens is compatible only with the blood of the same group, since the presence of antigens A and B leads to the development by the immune system of a patient in whose blood these antigens are absent, antibodies of the type anti-A and anti-B, which destroy these antigens.

Blood transfusion procedure, or how is blood transfusion performed?

The blood and transfusion system is prepared for the transfusion procedure. Usually, a vein in the elbow bend area is used as the insertion site.

The hematologist squeezes the forearm of the hand with a tourniquet, carefully inserts the needle into the vein and attaches a tube to it, which is connected to a filter and a dropper, which provides the necessary rate of blood flow. First, physiological saline is injected, after making sure that the system is functioning normally, they begin to inject blood. A plastic bag with blood is attached to the system and the transfusion procedure is started.

Test for compatibility with blood transfusion

After establishing the recipient's blood group, the container with blood intended for transfusion is sent for cross-testing. The patient's blood is mixed with a donated blood sample and ensured that there is no reaction between the patient's blood antibodies and the donated red blood cells.

Blood transfusion with low hemoglobin is prescribed only in emergency cases, when its level falls beyond the critical phase, namely less than 60 g / l. Thanks to these measures, not only iron levels are rapidly increasing, but overall well-being is improving significantly. Despite the pronounced positive effect of the procedure, the consequences of blood transfusion with low hemoglobin are not always predictable.

How is a blood transfusion performed to restore hemoglobin

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

The sequence of mandatory actions for blood transfusion:

• The doctor finds out if there are good reasons for transfusion, and if there are any contraindications. Taking an anamnesis in this case is mandatory, it is necessary to find out from the patient: whether a transfusion of a hemotransfusion medium was previously performed to increase hemoglobin, there were no allergic reactions or side effects, the presence of chronic diseases and other individual characteristics of the body that must be taken into account.
• After conducting laboratory studies of the patient's personal blood parameters, such as group and Rh factor. Additional confirmation of the initial data will be required already on the spot, that is, in the hospital. To do this, a re-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. In the event of even the slightest mismatch even in one indicator, blood transfusion in order to increase hemoglobin is not allowed. The doctor must make sure that the packaging is airtight, and the passport contains all the information regarding the number and date of the harvest, the name of the donor, his group and Rh, the name of the manufacturer's organization, the expiration date and the doctor's signature. The duration of storage of the donor blood transfusion composition varies from 20 to 30 days. But even with full compliance with all indicators during visual inspection, the specialist should not detect any extraneous clots or films in it. After a thorough quality check, a re-analysis is carried out to confirm the group and Rhesus.
• Compatibility is checked using the AB0 system, while donor blood is combined with the recipient's blood on a special glass.
• To check compatibility according to the Rh factor, two parts of the patient's serum mass of blood, one part of the donor's blood mass, a part of polyglucin, 5 milliliters of saline are added to a special test tube, and the reaction is observed during rotation.
• After studying the compatibility data, a biological test is carried out by injecting 25 milliliters of donor blood into the recipient. It is administered three times with an interval between injections of three minutes. At this time, the patient is closely monitored, if the heart rate and pulse are normal, the face is without signs of redness and the general state of 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 purpose. With low hemoglobin, an erythrocyte mass is transfused. This component of the blood flow is introduced 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 well-being, pulse, pressure, temperature, condition of the skin, with subsequent entry of information into the medical record.
• At the end of the process, the patient needs rest for two hours. For another day, he is under the supervision of a doctor, then he takes blood and urine tests.
• After the transfusion is completed, approximately 15 milliliters of the recipient's blood serum and the donor's red blood cell mass are left. They are stored in the refrigerator for about 2 days, if it becomes necessary 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 preparations and a special diet that includes foods rich in iron.

Possible consequences of a blood transfusion for raising hemoglobin

Before putting a dropper on the recipient, a series of tests for compatibility are carried out in order to avoid sticking (agglutination) of erythrocytes, which can be fatal. Despite the observance of preliminary safety measures when performing a blood transfusion with reduced hemoglobin, it is not always possible to avoid unforeseen consequences.

Types of complications during blood transfusion in order to increase hemoglobin:

• Reactive:
  • increase in body temperature;
  • syndrome of massive blood transfusions, may be associated with a larger than necessary amount of blood injected;
  • hemolytic shock, can develop with antigenic incompatibility of the blood, in such a situation, the breakdown of erythrocyte membranes occurs, which leads to poisoning of the body with metabolic products;
  • citrate shock, can only occur 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 with an allergy to the administered blood transfusion medium.

A hemocontact infection is possible when an emergency blood transfusion is necessary with a sharp decrease in hemoglobin and there is no time to maintain it. Without fail, 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 low hemoglobin

It is easy to determine the level of iron in the blood, for this you only need to take a blood test at the district clinic or diagnostic laboratory. The reason for passing the analysis may be an examination associated with a visit to the doctor or the presence of obvious signs indicating anemia. According to the results of the study, it will become clear what measures to restore iron in the body to prefer - iron-containing nutrition and drugs or blood transfusion to raise hemoglobin.

The most common symptoms of anemia include:

• Strong heartbeat and difficulty breathing.
• Fainting and dizziness.
• Pain in the head, sensation of ringing in the ears.
• Feeling of weakness and pain in the muscular system.
• Change in taste and smell.
• Change in the structure of the nails.
• Thinning, dry hair.
• Paleness and dryness of the mucous membranes and skin.
• Protracted lethargic, apathetic state, fatigue, depression.
• Reduced blood pressure, deviations in the work of the VGT system, cold lower extremities.

If the quantitative value of iron has not decreased much, then a person may not be aware of it. Or he begins to worry about the incessant feeling of fatigue, even after a full 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 the blood in red blood cells or a decrease in their number or volume. After all, as you know, it is on the red blood cells that one of the most important missions is assigned to supply all organs, systems and tissues of the body with oxygen and the subsequent removal of carbon dioxide. Therefore, with a strong deviation from the norm of the hemoglobin index, it may be necessary to resort to a blood transfusion to increase it.

Blood transfusion with insufficient hemoglobin in childhood

If you or your loved ones have one or more symptoms of reduced hemoglobin, you should contact the clinic to conduct a study of the composition of the blood flow.

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

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

Not infrequently, the need for transfusion to raise hemoglobin or eliminate the effects of anemia appears in newborns and, especially in premature babies. It should be borne in mind that prematurity always entails an insufficient hemoglobin index, but in the absence of a severe form of anemia, the iron level is completely restored on its own by the first year of life. In the case of a vital need for blood transfusion with low hemoglobin, a careful selection of donor blood will be required, since it is forbidden to use maternal blood in such a situation.

A blood transfusion for a newborn due to hemoglobin may be required for hemolytic anemia - this is when the blood of the mother and child is incompatible.

Hematologic anemia has a number of serious consequences:

• Inability to bear a fetus.
• The birth of a baby with edema.
• The appearance of severe jaundice.

With the timely detection of a severe form of anemia in the fetus during pregnancy, an intrauterine transfusion of erythrocyte mass is given to him. The procedure, in addition to following the standard measures for the selection of donor blood, testing for susceptibility and compatibility, takes place using ultrasound.

A normal level of hemoglobin is necessary for the implementation of all human life processes, the full formation of the body, and maintaining health. The indicator of iron in the bloodstream is one of the main ones for a healthy state of health. To maintain it in the norm, you only need to fully eat and devote as much time as possible to walks in the fresh air.

In contact with

Blood transfusions can lead to reactions and complications. Reactions are manifested in fever, chills, headache, some malaise. It is customary to distinguish 3 types of reactions: mild (increase in t° up to 38°, slight chills), medium (increase in t° up to 39°, more pronounced chills, slight headache) and severe (increase in t° above 40°, sharp chills, nausea ). The reactions are characterized by their short duration (several hours, rarely longer) and the absence of dysfunction of vital organs. Therapeutic measures are reduced to the appointment of symptomatic agents: heart, drugs, heating pads, bed rest. When the reactions are of an allergic nature (urticarial rash, itching of the skin, angioedema of the face), the use of desensitizing agents (diphenhydramine, suprastin, intravenous infusion of a 10% solution of calcium chloride) is indicated.

A more formidable clinical picture develops with post-transfusion complications. Their reasons are different. Usually they are caused by transfusion of incompatible blood (by group affiliation or Rh factor), much less often by transfusion of poor-quality blood or plasma (infection, denaturation, hemolysis of blood) and violations of the transfusion technique (air embolism), as well as errors in determining indications for transfusion blood, choice of transfusion technique and dosage. Complications are expressed in the form of acute heart failure, pulmonary edema, brain.

The time of development of transfusion complications is different and depends largely on their causes. So, with an air embolism, a catastrophe can occur immediately after the penetration of air into the bloodstream. On the contrary, complications associated with heart failure develop at the end or shortly after the transfusion of large doses of blood, plasma. Complications in the transfusion of incompatible blood develop quickly, often after the introduction of small amounts of such blood, less often a catastrophe occurs in the near future after the end of the transfusion.

The course of post-transfusion complications can be divided into 4 periods: 1) hemotransfusion shock; 2) oligoanuria; 3) recovery of diuresis; 4) recovery (V. A. Agranenko).

The picture of transfusion shock (I period) is characterized by a drop in blood pressure, tachycardia, severe respiratory failure, anuria, increased bleeding, which can lead to bleeding, especially if incompatible blood transfusion was performed during surgery or in the next few hours after it. In the absence of rational therapy, hemotransfusion shock can lead to death. In the II period, the patient's condition remains severe due to progressive impairment of kidney function, electrolyte and water metabolism, an increase in azotemia and increased intoxication, which often leads to death. The duration of this period is usually from 2 to 3 weeks and depends on the severity of kidney damage. The third period is less dangerous, when the function of the kidneys is restored, diuresis is normalized. In the IV period (recovery), anemization persists for a long time.

In the first period of transfusion complications, it is necessary to deal with severe hemodynamic disorders and prevent the negative impact of toxic factors on the functions of vital organs, primarily the kidneys, liver, and heart. Here, massive exchange transfusions of blood in a dose of up to 2-3 liters using one-group Rh-compatible blood of short shelf life, polyglucin, and cardiovascular agents are justified. In the II period (oliguria, anuria, azotemia), therapy should be aimed at normalizing water and electrolyte metabolism and combating intoxication and impaired renal function. The patient is placed on a strict water regime. Reception of liquids is limited to 600 ml per day with the addition of such an amount of liquid that the patient has excreted in the form of vomit and urine. Hypertonic glucose solutions (10-20% and even 40%) are shown as a transfusion fluid. At least 2 times a day, gastric lavage and siphon enemas are prescribed. With an increase in azotemia and increased intoxication, exchange transfusions, intra-abdominal and intra-intestinal dialysis, and especially hemodialysis using an artificial kidney apparatus, are indicated. In the III and especially in the IV periods, symptomatic therapy is carried out.

Pathological anatomy of complications. The earliest pathomorphological changes at the height of shock are detected from the side of blood and lymph circulation. There are edema and foci of hemorrhages in the membranes of the brain and its substance, in the lungs, hemorrhagic effusion in the pleural cavities, often small-point hemorrhages in the membranes and muscle of the heart, significant plethora and leukostasis in the vessels of the lungs, liver.

In the kidneys at the height of shock, a significant plethora of the stroma is revealed. However, the glomerular vasculature remains free of blood. In the liver, at the height of the shock, there is a sharply pronounced disintegration and edema of the vascular walls, an expansion of the pericapillary spaces, and fields of light liver cells with swollen vacuolated protoplasm and an eccentrically located nucleus are often detected. If death does not occur at the height of shock, but in the next few hours, then swelling of the epithelium of the convoluted tubules is observed in the kidneys, the lumens of which contain protein. Edema of the stroma of the medulla is extremely pronounced. Necrobiosis of the epithelium of the tubules appears after 8-10 hours. and is most pronounced on the second or third day. At the same time, the main membrane is exposed in many direct tubules, the lumen is filled with accumulations of destroyed epithelial cells, leukocytes and hyaline or hemoglobin cylinders. In case of death 1-2 days after blood transfusion, extensive areas of necrosis can be detected in the liver. If death occurs in the first hours after a blood transfusion of an incompatible group, along with pronounced circulatory disorders, accumulations of hemolyzed erythrocytes and free hemoglobin are detected in the lumen of the vessels of the liver, lungs, heart and other organs. Products of hemoglobin released during hemolysis of erythrocytes are also found in the lumen of the renal tubules in the form of amorphous or granular masses, as well as hemoglobin cylinders.

In the case of death from a transfusion of Rh-positive blood to a recipient sensitized to the Rh factor, massive intravascular hemolysis comes to the fore. Microscopic examination in the kidneys shows a sharp expansion of the tubules, their lumens contain hemoglobin cylinders, fine-grained masses of hemoglobin with an admixture of decaying epithelial cells and leukocytes (Fig. 5). After 1-2 days and later after blood transfusion in the kidneys, along with edema of the stroma, necrosis of the epithelium is detected. After 4-5 days, you can see signs of its regeneration, in the stroma - focal lymphocytic and leukocyte infiltrates. Kidney damage can be combined with changes in other organs characteristic of uremia.

With complications from the introduction of poor-quality blood (infected, overheated, etc.), signs of hemolysis are usually not pronounced. The main ones are early and massive dystrophic changes, as well as multiple hemorrhages on the mucous and serous membranes and in the internal organs, especially often in the adrenal glands. With the introduction of bacterially contaminated blood, hyperplasia and proliferation of reticuloendothelial cells in the liver are also characteristic. Accumulations of microorganisms can be found in the vessels of organs. During transfusion of superheated blood, widespread vascular thrombosis is often observed.

In cases of death from post-transfusion complications associated with hypersensitivity of the recipient, changes characteristic of hemotransfusion shock may be combined with morphological signs of an allergic condition. In a small part of cases, blood transfusion complications occur without a clinical picture of shock and are associated with the presence of contraindications to blood transfusion in patients. Pathological changes observed in these cases indicate an exacerbation or intensification of the underlying disease.

Rice. 5. Hemoglobin casts and granular masses of hemoglobin in the lumen of the tubules of the kidney.

Blood transfusion is one of the most common medical procedures for people of all ages. It consists in introducing into the body of one person blood previously taken from another person - a donor.

Why is a blood transfusion performed?

Blood transfusion is one of the most common medical procedures for people of all ages. It consists in introducing into the body of one person blood previously taken from another person - a donor. A transfusion may be required during surgery, to replenish blood lost due to a severe injury (such as a car accident), or to treat certain diseases and disorders. Blood transfusion is carried out thanks to a thin needle and a dropper. A needle is inserted into a blood vessel to draw out the required amount of blood. The procedure usually takes 1 to 4 hours. Before a transfusion, doctors must make sure that the blood type of the donor and recipient match.

Usually, donated blood is pre-collected and stored in a so-called blood bank. Donor blood donation is carried out both in specialized centers and directly in hospitals. It is quite possible to periodically donate your blood for your own use in the future (just in case). This procedure is called an autologous blood transfusion. It is often used before an upcoming operation. (It takes 4 to 6 weeks to build up the amount of blood needed for most surgeries. Your doctor can recommend a specific amount to draw, as well as how long it takes to restore your red blood cell count between each donation.) Your blood cannot be used in unplanned situations such as an accident.

Giving donated blood to a friend or family member is called a directed transfusion. It should be scheduled 4-6 weeks before the expected time of the transfusion.

How to keep healthy?

Most blood transfusions are successful and without any complications. Often, a preliminary study of the quality of blood and a clear definition of its group allows you to get the best result. After the transfusion, doctors check body temperature, blood pressure, and heart rate.

Blood tests can check the body's response to the transfusion. Also, as part of the preliminary examinations, the condition of the kidneys, liver, thyroid gland and heart, as well as the general level of health, are checked. They will also check how well your blood is clotting and how any medications you are taking are working.

Possible mild complications:

• Pain at the injection site of the needle.

Possible allergic reactions:

• Low blood pressure, nausea, heart palpitations, shortness of breath, anxiety, and chest and back pain.

Rare severe complications:

• Fever on the day of the transfusion.
• Liver damage due to excess iron.
• Unexplained lung damage within the first 6 hours after the procedure (in patients who were very ill before the transfusion).
• A severe or delayed reaction when the wrong blood type is given, or if the body attacks the donated red blood cells.
• Graft-versus-host disease is a disorder in which white blood cells from donated blood attack the tissues of the recipient's body.

Rigid preliminary procedures for examining the quality of donated blood and clearly defining its type make blood transfusion a safe procedure.

Many people worry about the possibility of receiving blood containing infections or viruses, such as , or variant Creutzfeldt-Jakob disease (a fatal brain disease - the human form of bovine spongiform encephalopathy). While these infections can indeed theoretically be transmitted through blood transfusion, the risk of such a scenario is extremely low.

Requirements for donors vary from country to country, but in general they must be adults weighing at least 50kg, whose health condition is carefully checked on the day of blood donation. Donors are also required to confidentially answer a series of questions to identify possible illnesses, lifestyle, general health, previous illnesses and risks associated with travel to other countries. For example, if a person has recently traveled to an epidemic region, they will not be allowed to donate blood until a certain period of time has passed. Similar questions are used to determine a person's lifestyle. Their purpose, in particular, is to identify situations with an increased risk of HIV/AIDS infection. Sometimes, based on the responses received, a potential donor is not allowed to donate blood. Subsequently, in the laboratory, the blood is carefully examined for the presence of viruses or infections.

Questions to ask your doctor

• How reliable is the content of blood in blood banks?
• If I travel outside my home country, do I need to get any additional information about blood transfusion and storage?
• If I decide to have an autologous or directed blood transfusion, how many months in advance do I need to start planning?

Blood transfusion, or autohemotherapy, is used to stimulate the body and increase its immunity. The procedure involves a transfusion of blood from a blood vessel that carries blood to the heart into the muscle. In this case, all the action can be carried out independently at home.

How to do a blood transfusion at home

The injection plan is prescribed by the doctor, however, if the patient has experience in giving injections, then the following schedule is recommended:

• daily blood injection is allowed. The first time - 2 ml, and later, every 2 or 3 days, increase the dose by the same number of milliliters (up to 10 ml). The entire period should not exceed 15 days;
• how long injections can be given also depends on their effect on the body. If the patient felt a noticeable improvement in his condition, then you can stop the blood supply. Therefore, the answer to the question of how often a blood transfusion can be done depends only on the patient's body.

Below are all the stages of classical autohemotherapy:

1. First you need to take blood from a vein and then immediately, without any impact on the liquid, inject it into the buttock. In this case, the action must occur very slowly in order to get rid of severe pain. The patient is advised to come into a relaxed state as much as possible. So everything will be more comfortable.
2. The surrounding area and all objects must be very clean, and the procedure can only be carried out by a person versed in the field of medicine.

How is a blood transfusion done for acne?

The principle of blood transfusion from acne is very similar to the usual one. However, in this case, the amount of injected blood is exceeded daily by only 1 ml. Therefore, the duration of the procedure is only 10 days.

Is it possible to do a blood transfusion at a temperature

After autohemotheremia, the temperature may rise. However, is it possible to do the procedure already with her? There is no temperature among the entire list of contraindications, however, since it can rise after the injection, it is not recommended to inject blood in this state.