Blood transfusion for anemia. Blood transfusion with low hemoglobin Is blood transfusion with low hemoglobin

Stages of blood transfusion

The donor's blood is first checked several times and carefully checked against the data on the container. Then a combination analysis is carried out.

If the donor blood compatibility is good, then intravenous administration is performed using a dropper. The infusion rate should not exceed 60 drops per minute.

During the procedure, the patient is under the supervision of a doctor who takes control measurements of pulse and body temperature.

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Anna Poniaeva. She graduated from the Nizhny Novgorod Medical Academy (2007-2014) and Residency in Clinical Laboratory Diagnostics (2014-2016).

When 15 ml remains in the package, the blood transfusion is stopped and stored in the refrigerator for a couple of days. If the patient develops complications, additional blood tests are performed.

Many of us do not suspect that frequently disturbing headaches, various ailments, insomnia or pale skin may indicate low hemoglobin. In most cases, good nutrition and taking iron supplements help bring it back to normal. However, there are situations when urgent blood transfusion is required when hemoglobin is low.

Causes of low hemoglobin

A decrease in hemoglobin in the blood can be for various reasons:

• this usually happens with obvious or hidden blood loss;
• after medical therapy that included aspirin or ibuprofen;
• lack of vitamin B12, iron, folic acid;
• incorrectly designed diets, especially for women.
• intoxication of the body;
• malignant diseases;
• disruption of the gastrointestinal tract.

Most often, when there is low hemoglobin in the blood, iron supplements, a varied diet and, if necessary, vitamin injections are prescribed.

When is the procedure scheduled?

Blood transfusions with low hemoglobin are not prescribed for everyone. Indications for the procedure are chronic anemia with clinical signs that cannot be eliminated for a long time with therapy prescribed by a doctor. These signs are:

1. general weakness;
2. frequent headaches;
3. tachycardia at rest;
4. shortness of breath at rest.
5. dizziness.

The hemoglobin level in this case does not play a special role. Infusion of erythros-containing components is prescribed in the following cases:

• with a decrease in oxygen delivery to mixed venous blood. If it is normal, in most cases a transfusion is not prescribed;
• for the treatment of patients with congenital heart defects;
• for acute blood loss in the postoperative period;
• in case of urgent surgery;
• patients with cerebral atherosclerosis, heart and pulmonary failure

Blood transfusion procedure

Today, for blood transfusions, not whole blood is used, but separated into plasma and other components. In case of iron deficiency anemia, only red blood cell suspension is used. For infusion, canned blood from a healthy donor is used. In this case, the blood type must be determined, which will avoid conflict of antigens.

Transfusion order:

1. The donated blood received is re-tested and compared with the labeling on the packaging in which it was stored.
2. Next, an additional study is carried out to determine compatibility with the patient’s blood.
3. If the result is positive, the donor’s blood is gradually injected into the patient’s vein. If the patient's condition is satisfactory, the rest of the blood is continued to be administered by drip.
4. The entire procedure is carried out under the full supervision of a doctor. To eliminate problems that may arise after a transfusion and establish the exact causes of their occurrence, a few milliliters of blood must be left. Leftovers can be stored for several days in the refrigerator.

Contraindications for blood transfusion

In case of vital indications for blood transfusion, contraindications may be narrowed.

The composition of human blood can be conditionally described as follows: plasma (liquid part), leukocytes (white cells responsible for immunity), erythrocytes (red cells that carry oxygen throughout the body), platelets, due to which the blood clots when injured.

Today we will talk specifically about red blood cells. They contain hemoglobin, which “transports” oxygen to all tissues and organs. If the level of red blood cells or hemoglobin in the blood decreases, they speak of anemia or anemia. In mild forms of this condition, a special diet and iron or vitamin supplements are prescribed. When hemoglobin is critically low, blood transfusion is the only way to save the patient.

Compatibility of blood groups for transfusion

In medicine, transfusion is called blood transfusion. The blood of the donor (healthy person) and recipient (patient with anemia) must match according to two main criteria:

• group;
• Rh factor.

Several decades ago it was believed that blood of the first group with a negative Rh factor was suitable for all other people, but later the phenomenon of red blood cell agglutination was discovered. It turned out that blood with the same group and Rh factor may be incompatible due to the so-called conflict. antigens. If you perform such a blood transfusion during anemia, the red blood cells will stick together and the patient will die. To prevent this from happening, more than one test is performed before blood transfusion.

It is worth noting that blood in its pure form is now already used, and depending on the indications for blood transfusion, transfusions of its components and preparations (plasma, proteins, etc.) are done. In case of anemia, the erythrocyte mass is indicated - this is what we will further mean by the concept of blood.

Blood samples

So, there is no universal blood group for transfusion, therefore:

If everything matches, a biological test is performed during blood transfusion. A patient with anemia is injected with 25 ml of red blood cells in a stream, wait 3 minutes. Repeat the same two more times with a three-minute interval. If after 75 ml of infused donor blood the patient feels normal, the mass is suitable. Further transfusion takes place by drip (40 - 60 drops per minute). The doctor must monitor this process. At the end of the blood transfusion, there should be about 15 ml left in the bag with donor red blood cells. It is stored in the refrigerator for two days: if complications arise after a blood transfusion, this will help determine the cause.

A normal hemoglobin level is considered to be between 120 and 180 g/l, depending on gender and age.

If this value decreases, a person begins to suffer from various unpleasant symptoms: weakness, dizziness, increased fatigue, etc.

This condition is called anemia, or anemia. What to do in this case?

Most often, to correct hemoglobin levels, it is enough to prescribe iron-containing drugs. But there are extremely advanced conditions in which conservative methods are not able to have the desired effect.

And then blood transfusion, or blood transfusion, comes to the rescue. Sometimes a blood transfusion with low hemoglobin is the only possible way to quickly normalize the patient’s condition and return him to a full life. Let's take a closer look at this procedure.

Indications for blood transfusion

Transfusion with low hemoglobin is not indicated for everyone. Typically, the procedure is performed only in the most severe cases, when the hemoglobin level falls below 60-65 g/l, depending on the clinical situation. What could cause such a strong decrease in hemoglobin content in the blood?

In some cases, a transfusion may be prescribed when the hemoglobin level drops to 100 g/l, for example, in patients with cardiac or pulmonary pathologies. In each specific situation, before prescribing a transfusion, the doctor takes into account not only hemoglobin levels, but also other parameters of the patient’s condition.

How does the procedure work?

For blood transfusion, not whole blood is used, but divided into components. In case of anemia (unless we are talking about anemia resulting from blood loss), only erythrocyte components of donor blood are used. The donor is selected based on blood type and Rh factor; they must match exactly. In addition, a number of compatibility tests are required.

The entire transfusion process takes place in several stages:

1. Studying the patient's medical history: risks are assessed, contraindications are excluded.
2. A laboratory determination of the patient’s blood type and Rh factor is carried out.
3. Suitable donor blood is selected, after which it is assessed for suitability for use: the tightness of the packaging and the appearance of the contents are checked, the data and expiration date are checked.
4. Individual compatibility is checked by mixing the patient's blood serum with elements of donor blood.
5. Compatibility is assessed by Rh factor.
6. Next, a biological compatibility test is carried out. To do this, the patient is injected with 25 ml of donor blood components three times under supervision. After which the patient's condition is assessed. If there is no deterioration in his health, then they proceed directly to a blood transfusion. The dosage is determined by the attending physician based on clinical data.
7. Red blood cell mass is administered dropwise at a rate of 40 to 60 drops per minute. In this case, there must be constant monitoring of the patient’s condition. The remainder of the donor blood and serum sample of the patient is stored for 2 days from the moment of transfusion in order to be able to analyze them in case of complications.
8. After the procedure, the patient must remain in a supine position for about 2 hours. Monitoring of the condition should be constant throughout the day.

A day after the transfusion, if hemoglobin is low, the success of the procedure is assessed by taking general urine and blood tests.

Positive effect of transfusion

The main purpose of transfusion with low hemoglobin is to bring the patient's condition back to normal as soon as possible. Blood transfusion also helps restore the volume of blood lost during bleeding.

The red blood cell mass that enters the body replenishes missing blood elements, improves blood circulation, and normalizes blood pressure. It helps the body fight oxygen starvation, restoring the normal supply of tissues and cells with oxygen, resulting in improved functioning.

Besides, The procedure helps to increase the body's protective functions and increases resistance to infections. Transfusion improves the metabolism and general condition of the patient.

Against this background, recovery from the underlying disease or pathology, which led to a strong decrease in hemoglobin levels, proceeds much faster and better.

Possible consequences and complications

Despite following basic safety rules when carrying out blood transfusion due to low hemoglobin, it is not always possible to avoid complications. Possible consequences of blood transfusion with low hemoglobin are divided into several groups, depending on the mechanism:

1. Jet:

• Hyperthermia (increased body temperature);
• Massive blood transfusion syndrome (occurs due to the transfusion of large volumes of donor blood and manifests itself in the development of bleeding);
• Hemolytic shock (result of transfusion of incompatible blood);
• Post-transfusion shock (occurs due to the use of low-quality donor blood, when it is overheated, its sterility is impaired, etc.);
• Anaphylactic shock (manifestation of an allergic reaction to components of donor blood);
• Citrate shock (reaction to preservatives in donor blood).

1. Mechanical:

• Sudden expansion of the heart due to too rapid supply of donor material through an IV;
• Embolism, which consists of air bubbles entering the blood vessels during transfusion;
• Blood clotting disorders and the formation of blood clots, which can clog blood vessels and disrupt the functioning of organs.

1. Infectious– infection with blood-contact infections (syphilis, hepatitis, HIV, etc.) through donor blood cells. This becomes possible if the timing of the control of donor blood, which should be carried out six months after the donation of the material, is violated. This situation can happen in the event of an emergency need for transfusion, when there is no time to recheck the donor material.

The time for the development of complications is always different and depends on their causes. Some of them may appear instantly. For example, embolism, which leads to rapid death. Some - only after a few hours. That is why constant monitoring of the patient after a transfusion is important, because untimely provision of medical care in case of complications can cost life.

How to protect yourself from complications

The basis for successful transfusion with low hemoglobin is compliance with all the rules and safety measures provided for by this procedure. What are they?

• Careful examination of the anamnesis: you need to know exactly whether similar procedures were performed in the patient’s history, whether there were operations or childbirth, how they went, what consequences appeared;
• Strict implementation of research techniques when determining blood group and Rh factor;
• Use of high-quality reagents and laboratory equipment;
• Mandatory individual compatibility test and biological test before blood transfusion;
• Careful observation and control of the patient's condition during the transfusion and within 24 hours after it (external assessment of the condition, pressure measurement, temperature control).

As statistics collected by leading institutions of the Blood Service show, negative consequences and complications arising from blood transfusions most often occur due to inattention and violation of the rules of the procedure.

Blood transfusion with low hemoglobin in oncology

In the presence of cancer, anemia becomes a frequent companion of the patient. There are several reasons for a decrease in hemoglobin levels in cancer:

1. Radiation therapy leads to severe disruption of hematopoiesis;
2. Surgical removal of tumors may be accompanied by large blood losses;
3. Cancer in later stages can disrupt the hematopoietic system;
4. The disintegration of a tumor under the influence of therapy can also lead to depletion of the body’s blood supply.

In all these cases, transfusion allows for a rapid increase in hemoglobin levels to normal values, which allows the patient to continue treatment. Indeed, during chemotherapy and radiation therapy, in the case of anemia, treatment often has to be postponed, and for cancer patients, delay can be fatal. Therefore, hemoglobin levels in cancer patients are constantly monitored, and if its level decreases, blood transfusion is prescribed according to established standards.

Anemia or anemia is a group of certain syndromes characterized by a decrease in hemoglobin in the blood, as well as a simultaneous decrease in the concentration of red blood cells in the blood. Anemia is not usually considered a disease. It is a symptom of various pathological conditions of the human body. Patients suffer, by which the picture of the development of the disease can be determined. To treat severe cases, blood transfusions are used for anemia.

Kinds

How much blood to transfuse and what components it should consist of must be determined by the doctor. It is necessary to remember about checking the compatibility of the blood of the donor and the patient, which is carried out before the blood transfusion procedure.

If the donor is not a relative of the patient, then it is necessary to re-check for compatibility. An analysis of the Rh factor is also carried out and, accordingly, . And only then, they begin blood transfusion using a filter with the required diameter and a sufficiently large catheter, continuously monitoring the recipient’s reaction for 10 minutes (first, transfuse 15 ml of red blood cells - watch the reaction for 3 minutes, then repeat this procedure two more times if nothing happens, then continue the process). AIDS, hepatitis and syphilis are mandatory before receiving a blood transfusion from a donor.

Doctors also practice preliminary mixing of the blood of the patient and the future donor in order to observe the reaction of compatibility or incompatibility. If blood is needed right now, then, as an option, you can use frozen. Red blood cell mass can retain its properties for quite a long time when frozen. It should be remembered that blood transfusion is a long process and it takes about 4 hours to give one dose to a patient. Thus, we have reviewed the basic rules of blood transfusion for anemia.

Rh factor compatibility

It should be remembered that blood transfusion for anemia is possible only if the Rh factors of the donor and recipient are compatible. Otherwise, the patient may develop anaphylactic shock. In this case, only transfusions to any other groups are permissible, but only for adults.

With blood transfusion, it is assumed that 1 blood group is, so to speak, multifunctional and can be transfused to any other group. is a universal recipient, meaning it accepts any donor’s blood group. But in practice, they are guided by the rules of compatibility of groups and Rh factors.

It must be remembered that, according to the rules, the second and third groups with a negative Rh factor are transfused to the recipient if he has the third, fourth and, accordingly, second blood groups; by the way, in this case the Rh factor no longer has any significance. If a patient has blood type IV with a Rh factor having a plus sign, then a donor with any blood group will be suitable for him.

Only the attending physician should deal with blood compatibility in case of anemia. If there is no time for a deeper check, then you need to double-check the results at least twice.