① Blood loss <500ml (10%), autoregulation, interstitial fluid → circulation ② If blood loss is 500~1000ml (10%-20%), inject crystalloid, colloid or a small amount of plasma substitute ③Blood loss >1000ml (20%), transfusion of concentrated red blood cells ④Blood loss >30%, half whole blood and half CRBC ⑤ If blood loss is >50%, pay attention to supplementing albumin, platelets, coagulation factors, etc.

① Mostly due to chronic blood loss and increased destruction of red blood cells ②Transfuse concentrated red blood cells to correct anemia based on the patient’s clinical manifestations and test results ③Supplement plasma or albumin to treat hypoalbuminemia

① Provide antibodies, complement, etc. ② Enhance anti-infection ability ③ Input concentrated granulocytes ④Refractory infection → When neutrophils are low and antibiotic treatment is ineffective, the infusion of concentrated granulocytes may be considered to help control the infection. May cause cytomegalovirus infection and pulmonary complications, use with caution

Hemophilia→Antihemophilic globulin Fibrinogen deficiency → Cryoprecipitate Thrombocytopenia → platelets

① Hb >100g/L, no need for blood transfusion ② Hb <70g/L, packed red blood cells can be transfused ③ If Hb is 70-100g/L, blood transfusion should be decided according to the patient’s specific condition. For patients who may or may not lose, try not to lose.

Platelet transfusion should be based on quantity or functional abnormalities associated with bleeding tendency or manifestations ① PLT >100x10⁹/L does not need to lose ② PLT <50x10⁹/L should be considered for loss ③ PLT is (50-100)x10⁹/L and should be determined based on whether the patient has bleeding tendency.

① PT (prothrombin time) or APTT (activated partial thromboplastin time) >1.5 times normal value, diffuse bleeding in the wound ②Major bleeding or transfusion of stored blood equivalent to the patient’s own blood volume ③Congenital or acquired coagulation disorder ④Emergency counteract the anticoagulant effect of warfarin

①The most common complications. The incidence rate is about 2%-10% ②Occurrence time: Within 15 minutes to 2 hours after the blood transfusion begins ③Clinical manifestations: Chill, chills and high fever, body temperature can reach 39~40℃ ④ Accompanying symptoms: sweating, headache, nausea, vomiting and skin flushing ◇ Symptoms may gradually ease, but blood pressure usually remains unchanged ⑤Severe cases: convulsions, difficulty breathing, drop in blood pressure, and even coma may occur

①Immune reaction: Common in multiparous women or those who have received multiple blood transfusions ② Pyrogen: The blood transfusion equipment or blood products used are pyrogen, which is rare. ③Bacterial contamination ④Hemolysis

①Those who have received multiple blood transfusions: transfuse blood components that do not contain white blood cells and platelets ② Emphasis should be placed on controlling pyrogens. Blood transfusion equipment should be strictly sterilized

①First analyze the possible reasons ②Slow down the blood transfusion speed. In severe cases, blood transfusion should be stopped. ③ Pay attention to symptomatic treatment. For those with chills, intramuscular injection of promethazine or pictidine can be given.

The time of appearance is not necessarily sooner or later. Mostly manifested as skin localization or generalized itching or urticaria Severe cases may cause bronchospasm, angioedema, epiglottis edema, and even anaphylactic shock, coma, and death.

①Patients with allergies are allergic to protein substances in the blood ② Blood donors with allergic constitution transfer certain antibodies in their body to the patient along with the blood, mainly IgE ③When patients receive multiple infusions of plasma products, a variety of antiserum immunoglobulin antibodies are produced in the body, mainly IgA.

Mild illness: Temporarily suspend blood transfusion and take the antihistamine diphenhydramine 25 mg orally. Severe cases: stop blood transfusion, inject epinephrine intramuscularly (1:1000, 0.5~1ml), subcutaneously Corticosteroids, endotracheal intubation or incision to prevent suffocation

①For patients with a history of allergies, take anti-allergic drugs and intravenous infusion of glucocorticoids half an hour before blood transfusion ②For patients with low IgA levels or detected IgA antibodies, IgA-free blood or blood products should be transfused ③Those with a history of allergies should not donate blood. ④ Blood donors should fast 4 hours before blood collection

The most severe and clinically manifest complications ①After infusion of 10 ml of blood with incompatible blood type, the patient ② Immediate redness, swelling and pain along the blood transfusion vein, chills, high fever, difficulty breathing, back pain, headache, chest tightness, and shock ③Hemoglobinuria and hemolytic jaundice will subsequently occur, and in severe cases, renal function damage may occur ④Surgical patients present with unexplained drop in blood pressure and bleeding in the surgical field ⑤ Delayed hemolytic reaction: fever, anemia, jaundice, hemoglobinuria 7-14 days after blood transfusion General Introduction to Surgery

① Transfusion of blood with incompatible blood types triggers a complement-mediated immune response. Including ABO blood type, A subtype, Rh and other blood group incompatibility; transfusion of blood from different donors in large quantities ② Transfusion of defective red blood cells (improper blood storage and transportation, adding hypertonic or hypotonic solutions or drugs that damage red blood cells, etc.) ③When the recipient suffers from autoimmune anemia, the autoantibodies in the blood can also destroy the transfused allogeneic red blood cells and induce hemolysis.

Emergency treatment: Stop blood transfusion immediately, check blood type again, draw venous blood and observe the plasma color after centrifugation Diagnosis: ① pink plasma ② positive urinary occult blood ③ hemoglobinuria Prevention: ① Strengthen verification during blood transfusion and blood matching. ② Strictly follow the blood transfusion procedures ③ Transfusion of same type of blood

① Anti-shock: transfusion + hormone → transfusion of fresh blood of the same type, platelets, coagulation factors and glucocorticoids. ② Protect renal function → Alkalinize urine: Give intravenous infusion of 5% sodium bicarbonate. Use mannitol, etc. to accelerate the discharge of free hemoglobin. In severe cases, hemodialysis may be considered ③Prevention and treatment of DIC formation: heparin ④Plasma exchange treatment: remove atypical red blood cells from the body; remove harmful antigen-antibody complexes

1. Contaminated bacteria have low virulence and small quantity → may only have a fever reaction 2. If the bacteria are highly virulent and numerous, transfuse 10~20ml of blood → endotoxic shock and DIC will occur immediately ①Patients may have irritability, chills, high fever, nausea, vomiting, difficulty breathing, cyanosis, abdominal pain and shock ② Manifestations such as hemoglobinuria, acute renal failure, and pulmonary edema may occur

Occurrence has nothing to do with age, gender and original disease Mechanism: Caused by leukocyte agglutinins or HLA-specific antibodies present in donor plasma Clinically, TRALI is often difficult to distinguish from ARDS not caused by blood transfusion, such as pulmonary infection, aspiration pneumonia, or toxin absorption.