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Blood bags and its anticoagulants

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Blood bags and its anticoagulants

  1. 1. BLOOD BAGS AND ITS ANTICOAGULANTS PRESENTER – DR.SOWMYA SRINIVAS
  2. 2. A BRIEF HISTORY OF BLOOD BANKING  1628 - William Harvey - circulation of blood.  1665 - First recorded successful blood transfusion - Richard Lower.  1818 - James Blundell - first successful transfusion of human blood to a patient.  1900 Karl Landsteiner - discovers the first three human blood groups.
  3. 3. MILESTONES IN BLOOD PRESERVATION HISTORY  1914: Albert Hustin and Luis Agote kept blood in the liquid state for 48 hours using citrate.  1943: John F. Loutit and Patrick L. Mollison introduced acid – citrate – dextrose preservative, the still used blood preservative.  1950: Carl Walter invented first plastic blood bag.  1963 – 1973: closed blood bag systems were developed to ensure the sterility.
  4. 4. INVENTION OF BLOOD BAGS  First invented by Dr.Carl Waldemar Walter.  Dr Walter was a surgeon, inventor, and professor at Harvard Medical School.  Walter has been called "a pioneer in the transfusion and storage of blood”  He is also credited with founding one of the world's first blood banks and invention of the first blood collection bag.
  5. 5. BLOOD BAGS  Blood bags are designed for the collection, processing and storage of whole blood and blood components.  They help in providing aseptic conditions for the separation of blood components.  It acts as a closed system reducing the chances of contamination.
  6. 6. CONSTRUCT OF A BLOOD BAG  Blood bags are made with high molecular weight PVC to ensure better tensile strength and weld strength.  Validated sterilization process is used.  The process is monitored automatically with a data logger which confirms the product sterility.  Triple filtration of anticoagulant is done and is filled in the bags automatically to ensure accuracy.  Advanced and standardized coiling method is used to prevent kinks, which ensures a free flow during collection and separation.
  7. 7. Packaging:  Secondary Packaging is made of laminated polyester/aluminium/polyethylene.  Reduces moisture loss.  Assures external sterility.  Protects bag from damage.
  8. 8. Tubing  It ensures a better yield of components without damage during blood collection.  Very clear printing over the tubes ensures easy identification of samples.  Stable wall thickness and inner diameter ensures the smooth flow and collection of blood.
  9. 9. Label  Labels are clear and easy to understand.  Resistant to tear, water and centrifugation force
  10. 10. Outlet Port Pouch  Each outlet port is fitted with a hermetically sealed protector to maintain sterility of the internal surface  Can be opened with single – handed operation.
  11. 11. Needle  Ultra thin walled silicone coated needle.  High quality needle for smooth phlebotomy  Minimal stress to the donor Needle Protector :  Composed of two parts  The outer layer is made of hard polypropylene to ensure rigidity of cap  The inner layer is made of PVC to ensure hermetic closure with the hub
  12. 12. SAFETY FEATURES OF BLOOD BAGS Needle injury protector  Provides immediate shielding of needle on withdrawal from vein.  Reduces the risk of needle stick injury from both phlebotomy and sampling needles.  Improves safety in blood banks.
  13. 13. Pre-donation bag (PDB)  Diverts 10-30 ml of initial blood.  Enables diversion and collection of the first amount of blood which usually contains skin particles and bacteria.  Risk of bacterial sepsis is minimized
  14. 14. TYPES OF BLOOD BAGS Single Blood Bag:  For whole blood collection.  The bag contains CPDA solution.  Available in capacity of 350ml and 450ml.
  15. 15. Double Blood Bag:  For whole blood collection  Separation of 2 different blood components (red blood cells and plasma) obtained through the process of centrifugation and extraction.
  16. 16. Triple Blood Bag:  Triple Blood Bag with SAGM, for whole blood collection  Separation of 3 different blood components (red blood cells, plasma and platelets).  The primary bag contains CPD and one satellite bag contains SAGM.
  17. 17. Quadruple Blood bag:  It comes with SAGM for whole blood collection  Separation for 3 different blood components (red blood cells, plasma and platelets) through the buffy coat method.  The primary bag - CPD solution and has 3 satellite bags.  One satellite bag - 100 ml capacity to prepare platelets through the buffy coat method.  Valid for 5 days of platelet storage.
  18. 18.  Cord blood collection bag: Umbilical cord blood collection bag of 150 ml capacity with 22 ml of CPD solution. Each bag comes with a second layer of packing of aluminium foil for the convenience of cord blood collection centres.
  19. 19. BLOOD TRANSFER BAG:  For use with blood bag for transfer or pooling of blood and blood components.
  20. 20. Top and Bottom Bag:  Top and Bottom Quadruple blood bags are for whole blood collection and separation of three different blood components (red blood cells, plasma and platelets).  The primary bag contains CPD solution and one satellite bag comes with SAGM solution for red cell preservation.  Platelets are prepared from the buffy coat method.  One transfer bag is valid for 5 days of platelet storage.
  21. 21. TOP AND BOTTOM BAG
  22. 22. Top and Bottom Blood Bag with Leukocyte filter:  Top and Bottom penta blood bag with a leucocyte filter for whole blood collection and separation of 3 different blood components (leucodepleted red blood cells, plasma and platelets).  The primary bag contains CPD solution and one satellite bag is attached to a leucocyte filter which comes with SAGM solution for red cell preservation.  Platelets are prepared from the buffy coat method.  One transfer bag is valid for 5 days of platelet storage.
  23. 23. PRECAUTONS TO BE TAKEN  Hermetic sealing of the blood bag tubing should be done to ensure sterility of the blood collected.  Blood bags and sample tubes should be correctly labelled.  Manufacturing and expiry date should be noted.  Any blood bag that has leaked should be disposed off appropriately and the remaining bags should be disinfected.  Donor’s name should not appear on blood bags or samples.
  24. 24. STORAGE OF BLOOD BAGS
  25. 25. ANTICOAGULANTS IN BLOOD BAGS
  26. 26. A BRIEF HISTORY  1916 - First anticoagulant preservative - Rous and Turner.  It consisted of a citrate-glucose solution.  Rous Turner's solution was used for storage of human blood during the First World War (Mollison 1987).  1943 - during the Second World War, Acidified Citrate Dextrose (ACD) solution was introduced - Loutit and Mollison.
  27. 27.  1957 - Gibson et al developed citrate-phosphate-dextrose (CPD)  CPD eventually replaced ACD and became commonly used preservative for storage of blood/red cells in liquid form.  Shelf-life of blood stored in CPD at 2-4 °C was 21 day.  1978 - citrate-phosphate-dextrose with adenine (CPDA-1).  The addition of adenine improved the synthesis of ATP in the stored blood, which prolonged the storage of blood/red cells at 2-4 °C to 35 days.
  28. 28. ANTICOAGULANT PRESERVATIVE SOLUTIONS  Acid Citrate Dextrose (ACD)  Citrate Phosphate Dextrose (CPD)  Citrate Phosphate Dextrose Adenine (CPDA-1) 15 ml of ACD, 14ml of CPD or CPDA is used for preserving 100ml of blood. PURPOSE:  To prevent coagulation.  To preserve the life and survival of RBCs so as to have the maximum post transfusion survival.
  29. 29. COMPOSITIONS OF PRESERVATIVES/ANTICOAGULANTS ACD CPD CPDA-1 Tri sodium citrate (g) 22.0 26.30 26.30 Citric acid (g) 8.0 3.27 3.27 Dextrose (g) 24.6 25.50 31.8 Sodium di hydrogen phosphate (g) (monohydrate) - 2.28 2.22 Adenine (g) - - 0.275 Distilled water (ml) 1000 1000 1000 Preservative (ml) / 100ml blood 15 14 14 Preservative(ml) / 350ml blood 52.5 49 49 Preservative (ml) / 450 ml blood 67.5 63 63 Storage time (days) at 2-6 °C 21 21 35
  30. 30. ACTION OF INGREDIENTS OF ANTICOAGULANT SOLUTION  CITRATE: Acts by chelating Calcium.  DEXTROSE: Necessary for the metabolism of stored RBCs. It passes from plasma into the red cells and is utilised for energy production. The principal pathway being Anaerobic glycolysis.  CITRIC ACID: Prevents carmalization of glucose in citrate dextrose solution during autoclaving.  ADENINE: Improves the viability of red cells.
  31. 31. CPDA - 2  Here the amount of Adenine is increased to 0.55g and that of dextrose to 44.6g.  This is a better anticoagulant preservative solution than CPDA–1.
  32. 32. ADDITIVE SOLUTIONS  Additive solutions are preserving solutions that are added to the RBCs after removal of the plasma with/without platelets.  Reason for their development - removal of the plasma component during the preparation of RBC concentrates removed much of the nutrients needed to maintain RBCs during storage.  Also overcome the problem of high viscosity of RBC concentrates.  With CPD anticoagulant in the primary bag, the additive solution used is SAGM (saline, adenine, glucose, mannitol)
  33. 33. ADVANTAGES  Extends the storage of RBCs.  Lowers the viscosity of packed red cells for ease of transfusion.  Maximum amount of fresh plasma is harvested – platelets and cryoprecipitate.

Notas del editor

  • After which manufacturing and storage of blood became possible

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