Basic principles of blood transfusion

Blood transfusion is an effective way to save lives and cure diseases, and it is also a widely used treatment method in today's clinical medicine. Of course, although blood transfusion is an effective treatment method, there are certain risks in the process of blood transfusion, so certain principles need to be followed when transfusing blood. So, what are the basic principles of blood transfusion? This will be introduced below!

1. Cross-matching

In clinical practice, the preferred blood type cross-matching test is to use the same blood type when performing blood transfusion. Mixing the donor's red blood cells with the recipient's serum is called the primary side (direct blood matching); mixing the recipient's red blood cells with the donor's serum at the same time is called the secondary side (indirect blood matching). Blood transfusion can only be performed if there is no agglutination reaction on both sides. If agglutination reaction occurs, especially agglutination on the dominant side, blood transfusion must not be performed.

2. Surgery and Trauma

Severe trauma or acute blood loss caused by surgery may cause the patient to suffer from hypovolemic shock. Early and effective volume expansion is the key to improving prognosis.

1. Emergency resuscitation: Warm crystalloid solution 20-30 ml/kg or colloid solution 10-20 ml/kg and rapidly infuse within 5 minutes. Further blood transfusion will be decided based on the infusion effect.

2. Crystalloid first, then colloidal solution: The amount of crystalloid solution used should be at least 3 to 4 times the amount of blood loss. When the amount of blood loss is >30% of the blood volume, colloid solution can be considered. The ratio of crystalloid to colloidal solution is usually 3:1.

3. Red blood cell transfusion: After volume expansion to restore cardiac output and tissue blood perfusion, if the patient is young and has good cardiopulmonary function, blood transfusion is not necessarily required. When there are obvious symptoms of anemia, red blood cell transfusion can be used to correct tissue hypoxia.

3. Principles of blood transfusion in burn department

1. Increased capillary permeability in burn patients can lead to a decrease in blood volume throughout the body (decreased cardiac output, decreased blood pressure, oliguria or shock), while blood concentration can lead to microcirculatory congestion and affect the perfusion of tissues and organs. Therefore, resuscitation using only crystalloids is safe and effective (for the use of crystalloids and colloids, please refer to the transfusion principles in the first section of this chapter).

2. Anemia that occurs in burn patients in the short term is generally not serious, but as time goes by and treatment is implemented, anemia becomes increasingly obvious and blood transfusion may be considered.

3. Fresh frozen plasma should not be used as a volume expander or wound healing agent in the early stages of burns. It can only be considered for infusion supplementation in later treatment when there is no substitute due to the loss of coagulation factors.