输血-英语课件

BloodtransfutionBloodtransfutionBloodTransfusion2BloodTransfusion2HistoryTypeofTransfusionIndicationTransfusionReactionsAutologoustransfusionComponentTransfusionBloodTransfusion3HistoryBloodTransfusion3HistoryandSignificance4HistoryandSignificance4Lower

(1665)Firstbloodtransfusion5Lower(1665)FirstbloodtransPhilip(1825)Firsthumanbloodtransfusion6Philip(1825)FirsthumanbloodLandsteiner

(1900)

DiscoveryofABOtype7Landsteiner(1900)

DiscoveryoHowtostorebloodlonger?WorldwarI8Howtostorebloodlonger?WorlIsthereanysuitable

BloodSubstitutesWorldwarII9IsthereanysuitableWorldwarSuccessfulbloodtransfusionisrelativelyrecentCrossmatchingAnticoagulationPlasticstoragecontainerBloodTransfusion10SuccessfulbloodtransfusioniTypeofTransfusion：WholeBlood；BloodComponent；

RBCPLTFFPLeukocyteconcentrate

PlasmaSubstitutes；UseofwholebloodisconsideredtobeawasteofresourcesBloodTransfusion11TypeofTransfusion：WholeBlooSymptomaticanemia(providingoxygen-carryingcapacity)Transfusiontrigger(HCT<30%;HB<10g/dl)1Unitincreases3%HCTor1g/dlShelflife=42d(1-6℃)RedBloodCells12Symptomaticanemia(providingThrombocytopenia(<50,000)PlateletdysfunctionEachunitincrease5,000PLTsafter1HPlatelets13ThrombocytopeniaPlatelets13Profoundlygranulocytopenia(<500)SeriousinfectionnotresponsivetoantibiotictherapyGranulocytes14Profoundlygranulocytopenia(<Coagulationfactordeficiencies1mlincreases1%clottingfactorsBeingusedassoonaspossibleAlbumin,hetastarch,crystalliodsareequallyeffectivevolumeexpanderbutsaferthanFFPAfteruseof5UofRBCs,matching2UofFFPFreshFrozenPlasma(FFP)15Coagulationfactordeficiencie--VolumeExpanderDextranMostwidelyusedLow/MiddleM.W.(40,000-70,000)MassivetransfusioncouldimpaircoagulationOccasionalALLERGICreactionHydroxyethylStarchFormulation(HES)MorestableContainingessentialelectrolytesNoallergicreactionPlasmaSubstitutes16--VolumeExpanderDextranPlasmaIndication：Acutemassivebloodloss;Anaemiaandhypoalbuminemia;OverwhelmingInfection;DysfunctionofCoagulation;BloodTransfusion17Indication：AcutemassivebloodTechniqueofTransfusion:ApproachRoute:

PeripheralVein,CenterVeinFiltrationbeforeTransfusion：VelocityofTransfusion：

5-10ml/minBloodTransfusion18TechniqueofTransfusion:ApproDoubleCheck:Name,TypeandCrossmatchStorageTime: CitratePhoshateDetrose AcidicCitrateDetrose

21D,35DPre-heat：NoanyotherMedication：Observationduring/afterTransfusion：Attention：BloodTransfusion19DoubleCheck:Name,TypeandC Incidence：2% Chills,Fever39-40.C Headache,Sweatiness Nausea,Vomiting,Flushing 15min-1hr FebrileReactions：TransfusionReactions20 Incidence：2%FebrileReactionsImmuno-reaction：Endo-toxins：ContaminationorHemolysis： Analyzepossiblereasons：StopTransfusion：GeneralSupport： Treatment：FebrileReactions：TransfusionReactions21Immuno-reaction：Analyzepossi Urticaria Abdominalcramps Dyspnea

Vomiting Diarrhea Anaphylacticreactions：TransfusionReactions22 Urticaria AnaphylacticreactiImmuno-reaction： IgEHereditaryImmunoglobulin：IgAReason：AdministerantihistaminesAdministerepinephrine,diphenhydramine,andcorticosteroids：Supportairwayandcirculationasnecessary：Treatment：Anaphylacticreactions：23Immuno-reaction： I Burningattheintravenous(IV)linesite Fever,Chills,Dyspnea Shock CardiovascularCollapse Hemoglobinuria,Hemoglobinemia RenalFailure DIC HemolytictransfusionreactionsTransfusionReactions24 Burningattheintravenous(IABOincompatibilityRhIncompatibilityNon-immuneHemolysisImmuneHemolysis Reasons：HemolyticTransfusionReactions25ABOincompatibilityReasons：HeStopTransfusionassoonasreactionissuspectedCheckthename,typeandcrossmatchUrineExam RenalProtection (AggressiveFluidResuscitation,Furosemide)DICMonitor Treatment：HemolyticTransfusionReactions26StopTransfusionassoonasreDoubleCheckname,typeandcrossmatchOperatecarefullyandroutinely TemperatureMonitorPrevention：HemolyticTransfusionReactions27DoubleCheckname,typeandcroMassivetransfusioncomplications: VolumeOverload CongestiveHeartFailure Tachycardia Tachypnea Cyanopathy TransfusionReactions28MassivetransfusioncomplicatiVolumeOverloadHeartFunctionalFailureLungFunctionalFailure Reasons：StopTransfusionHeartFunctionalSupportDiuresis (Furosemide)Treatment：MassiveTransfusionComplications:29VolumeOverloadReasons：StopTrContamination: Fever Shock DIC

BacterialContamination Reasons：TransfusionReactions30Contamination: Fever BacterialStopTransfusionBacterialExamandCultureAntibiotics Treatment：DoubleCheckOperatecarefullyPrevention：Contamination:31StopTransfusionTreatment：DoubHepatitisB,HepatitisCHIVCytomegalovirus(CMV)SyphilisMalariaAcquireddiseases：TransfusionReactions32HepatitisB,HepatitisCAcquir经常不断地学习,你就什么都知道。你知道得越多,你就越有力量StudyConstantly,AndYouWillKnowEverything.TheMoreYouKnow,TheMorePowerfulYouWillBe学习总结33经常不断地学习,你就什么都知道。你知道得越多,你就越有力量学结束语当你尽了自己的最大努力时，失败也是伟大的，所以不要放弃，坚持就是正确的。WhenYouDoYourBest,FailureIsGreat,SoDon'TGiveUp,StickToTheEnd演讲人：XXXXXX时间：XX年XX月XX日

34结束语34BloodtransfutionBloodtransfutionBloodTransfusion36BloodTransfusion2HistoryTypeofTransfusionIndicationTransfusionReactionsAutologoustransfusionComponentTransfusionBloodTransfusion37HistoryBloodTransfusion3HistoryandSignificance38HistoryandSignificance4Lower

(1665)Firstbloodtransfusion39Lower(1665)FirstbloodtransPhilip(1825)Firsthumanbloodtransfusion40Philip(1825)FirsthumanbloodLandsteiner

(1900)

DiscoveryofABOtype41Landsteiner(1900)

DiscoveryoHowtostorebloodlonger?WorldwarI42Howtostorebloodlonger?WorlIsthereanysuitable

BloodSubstitutesWorldwarII43IsthereanysuitableWorldwarSuccessfulbloodtransfusionisrelativelyrecentCrossmatchingAnticoagulationPlasticstoragecontainerBloodTransfusion44SuccessfulbloodtransfusioniTypeofTransfusion：WholeBlood；BloodComponent；

RBCPLTFFPLeukocyteconcentrate

PlasmaSubstitutes；UseofwholebloodisconsideredtobeawasteofresourcesBloodTransfusion45TypeofTransfusion：WholeBlooSymptomaticanemia(providingoxygen-carryingcapacity)Transfusiontrigger(HCT<30%;HB<10g/dl)1Unitincreases3%HCTor1g/dlShelflife=42d(1-6℃)RedBloodCells46Symptomaticanemia(providingThrombocytopenia(<50,000)PlateletdysfunctionEachunitincrease5,000PLTsafter1HPlatelets47ThrombocytopeniaPlatelets13Profoundlygranulocytopenia(<500)SeriousinfectionnotresponsivetoantibiotictherapyGranulocytes48Profoundlygranulocytopenia(<Coagulationfactordeficiencies1mlincreases1%clottingfactorsBeingusedassoonaspossibleAlbumin,hetastarch,crystalliodsareequallyeffectivevolumeexpanderbutsaferthanFFPAfteruseof5UofRBCs,matching2UofFFPFreshFrozenPlasma(FFP)49Coagulationfactordeficiencie--VolumeExpanderDextranMostwidelyusedLow/MiddleM.W.(40,000-70,000)MassivetransfusioncouldimpaircoagulationOccasionalALLERGICreactionHydroxyethylStarchFormulation(HES)MorestableContainingessentialelectrolytesNoallergicreactionPlasmaSubstitutes50--VolumeExpanderDextranPlasmaIndication：Acutemassivebloodloss;Anaemiaandhypoalbuminemia;OverwhelmingInfection;DysfunctionofCoagulation;BloodTransfusion51Indication：AcutemassivebloodTechniqueofTransfusion:ApproachRoute:

PeripheralVein,CenterVeinFiltrationbeforeTransfusion：VelocityofTransfusion：

5-10ml/minBloodTransfusion52TechniqueofTransfusion:ApproDoubleCheck:Name,TypeandCrossmatchStorageTime: CitratePhoshateDetrose AcidicCitrateDetrose

21D,35DPre-heat：NoanyotherMedication：Observationduring/afterTransfusion：Attention：BloodTransfusion53DoubleCheck:Name,TypeandC Incidence：2% Chills,Fever39-40.C Headache,Sweatiness Nausea,Vomiting,Flushing 15min-1hr FebrileReactions：TransfusionReactions54 Incidence：2%FebrileReactionsImmuno-reaction：Endo-toxins：ContaminationorHemolysis： Analyzepossiblereasons：StopTransfusion：GeneralSupport： Treatment：FebrileReactions：TransfusionReactions55Immuno-reaction：Analyzepossi Urticaria Abdominalcramps Dyspnea

Vomiting Diarrhea Anaphylacticreactions：TransfusionReactions56 Urticaria AnaphylacticreactiImmuno-reaction： IgEHereditaryImmunoglobulin：IgAReason：AdministerantihistaminesAdministerepinephrine,diphenhydramine,andcorticosteroids：Supportairwayandcirculationasnecessary：Treatment：Anaphylacticreactions：57Immuno-reaction： I Burningattheintravenous(IV)linesite Fever,Chills,Dyspnea Shock CardiovascularCollapse Hemoglobinuria,Hemoglobinemia RenalFailure DIC HemolytictransfusionreactionsTransfusionReactions58 Burningattheintravenous(IABOincompatibilityRhIncompatibilityNon-immuneHemolysisImmuneHemolysis Reasons：HemolyticTransfusionReactions59ABOincompatibilityReasons：HeStopTransfusionassoonasreactionissuspectedCheckthename,typeandcrossmatchUrineExam RenalProtection (AggressiveFluidResuscitation,Furosemide)DICMonitor Treatment：HemolyticTransfusionReactions60StopTransfusionassoonasreDoubleCheckname,typeandcrossmatchOperatecarefullyandroutinely TemperatureMonitorPrevention：HemolyticTransfusionReactions61DoubleCheckname,typeandcroMassivetransfusioncomplications: VolumeOverl