Professional Documents
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TRANSFUSI DARAH
SELAMAT DATANG
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Blood Component Preparation
“A little goes a long way”
Blood Transfusion
Transfusi Darah
Indikasi
Efisiensi
Identifikasi
Cara pemberian
Pengamanan lingkungan
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Indikasi:
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BLOOD LOSS- signs, symptoms and
indication for transfusion
Volume Lost Clinical signs Preparation of choice
mL % of Total
Blood Volume
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Efisiensi:
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Tujuan transfusi darah:
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Identifikasi:
Sebelum pemberian darah, sebaiknya identifikasi
penderita terlebih dahulu :
Nama
Jenis kelamin
Umur
Nomor ruangan/kamar
Diagnosa
Golongan darah
Nomor kantong darah
hendaknya dicocokkan terlebih dahulu dengan
data pada formulir pengiriman darah dari UTD.
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Cara pemberian:
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Pemanasan darah :
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Pengamanan lingkungan:
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Sediaan Darah:
1.Darah lengkap :
Whole Blood.
Fresh Whole Blood.
2.Eritrosit :
Packed Red Cells.
Washed Red Cells.
3.Trombosit.
4.Darah kaya lekosit.
5.Plasma Darah:
Plasma Cair
Plasma kering.
Fresh Frozen Plasma.
Kriopresipitat.
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Darah Lengkap Segar:
Eritrosit Pekat :
PRC.
WRC.
Plasma Kaya Trombosit:
Trombosit Pekat.
Plasma Segar Beku - 60° :
Kriopresipitat.
Komponen lain.
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Darah Lengkap:
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Indikasi pemberian Darah
Lengkap:
1. Kehilangan darah akut:
Trauma atau
Operasi yang banyak mengeluarkan darah.
2. Transfusi ganti:
Pada bedah jantung terbuka.
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Washed Red Cells (PRC Cuci):
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Konsentrat trombosit:
1. Random-donor platelet:
Dikumpulkan dari beberapa orang ,setiap kantong mengandung 5,5x1010
dalam 50-70 ml.
Dapat disimpan 5 hari dlm temp. 20-24°C.
2. Single-donor platelet:
Dikumpulkan dari satu orang donor saja, mengandung 3x1011 dalam 200-
500 ml.
Setara dengan 6-8 unit random-donor.
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Indikasi pemberian trombosit:
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Platelet transfusion-indication(1)
1. Temporary thrombocytopenia occuring after radio- and
chemotherapy
• platelet count below 5 G/L
• platelet count 6-10 G/L and:
- minor hemorrhagic signs such as petechiae or small
ecchymoses of the skin
- fever >38oC
• platelet count 11-20 G/L
- coexisting deficiency of coagulation factors
- heparin administration
- before lumbar puncture and and bone marrow biopsy
• platelet count above 20G/L
- hemorrhagic diathesis
- before invasive procedure
Platelet transfusion-
indication(2)
2. Bleeding in patients with thrombocytopenia or
functional platelet abnormality
3. After massive transfusion(RBC) and
thrombocytopenia
4. Cardiac surgery with extracorporeal circulation
Granulocyte transfusions
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Indications for plasma
transfusions
1. Corrections of known congenital or acquired coagulation
factor deficiencies(e.g., factors II, V, VII, X, XI, or XIII) in
patients with hemorrhage
2. Urgent reversal of warfarin effect
3. Treatment of microvascular hemorrhage in the presence
of prolonged PT, aPTT
4. Treatment of microvascular bleeding following massive
blood transfusion when timely reporting of laboratory
test result is not available
5. Plasma exchange for TTP
Plasma segar beku :
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Kriopresipitat:
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Albumin:
Kekurangan albumin:
Sindroma nefrotik.
Malnutrisi.
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Indications for albumin
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Clinical use of intravenous immunoglobulin(2)
II. Nonifectious uses of intravenous immunoglobulin
1. Proven benefit
- Kawasaki syndrome
- Immune thrombocytopenic purpura
- Guillain-Barre syndrome
- Dermatomyositis
2. Probable benefit
- immune neutropenia
- autoimmune hemolytic anemia
- myastenia gravis
3. Possible benefit
- anticardiolipin antibody syndrome
- toxic shock syndrome
Fibrinogen:
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PPSB:
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“Blood is the most
dangerous
medication that a
physician ever
prescribes”
“Blood is the most
dangerous
medication that a
physician ever
prescribes”
Blood Transfusion Reactions
Haemovigilance
Serious Hazards of Transfusion ( SHOT
)65% Incorrect Blood Component
10% Acute Transfusion Reaction
3% Post-transfusion purpura
1% Transfusion-GVHD
Blood Transfusion: Delayed
Reactions
A. Faktor darah:
1. Ketidak sesuaian golongan darah ABO atau Rh
hemolitik:
Menggigil dan demam
Sakit pinggang, dada dan perut
Ikterus, hemoglobulinemia, hemoglobuliuria
Bisa shock
Oliguria
DIC
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Reaksi hemolitik:
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Tindakan pd reaksi
hemolitik:
Hentikan transfusi
Kortikosteroid
Manitol
Dll.
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Penyulit transfusi:
2. Darah hemolisa:
Darah simpan ( 4° C ) kemudian
dipanaskan terlalu kuat sebelum
ditransfusikan akan mengalami hemolisa.
Darah yang disimpan lebih dari 21 hari
sudah banyak mengalami hemolisa.
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Penyulit transfusi:
3. Reaksi pirogen :
Sering terjadi pada orang-orang dengan
riwayat alergi maupun asma bronkiale.
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Tindakan pd reaksi pirogen:
Hentikan transfusi
Antipiretik
Kortikosteroid
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Penyulit transfusi:
4. Pemindahan penyakit:
Malaria
Sifilis
Hepatitis
Virus lain
HIV
Mononukleosus infeksiosa
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Penyulit transfusi:
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Tindakan pd over transfusion:
Hentikan transfusi
Lasix iv.
Morfin.
Oksigen
Torniket
Flebotomi
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Penyulit transfusi:
6. Emboli udara:
Transfusi terlalu cepat dan dengan
tekanan.
Tanda: sesak nafas hebat, sianosis, TD
turun, nadi cepat, sinkope.
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Tindakan pd emboli:
Slang di klem
Penderita miringkan kekiri
Kepala rendahkan
Tungkai tinggikan
Oksigen.
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Penyulit transfusi:
7. Tromboflebitis.
8. Suhu darah yang tidak sesuai.
9. Mikroemboli.
10. Hemosiderosis.
11. Perdarahan :
Transfusi masif ok pengenceran faktor-faktor
pembeku.
12. Reaksi demam:
Sering terjadi pada pasien yang telah mendapat
transfusi sebelumnya.
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Faktor Resipien:
1. Reaksi alergi:
Urtikaria besar
Eritema
Edema sekeliling mata
Kadang-kadang TD turun
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Tindakan pd reaksi alergis:
Transfusi dilambatkan
Bila perlu transfusi hentikan
Beri :
Adrenalin
Antihistamin
Kortikosteroid.
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Faktor resipien:
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Determination Of Blood
Compatibility Of Donor And
Recipient
Golongan darah
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Ringkasan gol darah,antigen sel darah
merah &kemungkinan genotype
Human Red cell Serum Possible
blood antigens antibodies genotype
group
A A antigen Anti-B AA atau
AO
B B antigen Anti-A AA atau
BO
O none Anti- Hanya OO
A&anti-B
AB Adan B None Hanya AB
antigen
Serological characteristics of Blood
Groups
Determination of Blood Groups
In System ABO
Determination of Blood Groups
In System ABO
Determination of Blood Groups
In System ABO
Cells v Serum Serum v Cells
Faktor Rhesus
Rh - ~~~ genotipe r r
Peranan Faktor Rh Dalam Klinik
D Ag is highly immunogenic
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Setting up the Transfusion
Units of blood are stored in the ‘blood
bank’ fridge or theatre fridge.
You will need all the patient’s details
prior to going to collect any blood
products
Check details of blood report form
against unit of blood.
[Do not accept any wrong or missing
details]
You will need to sign for the unit in
blood bank register; The responsibility
is therefore yours!
Start transfusion within 30 minutes of
blood being removed from the fridge.