Transfusion Exchange

Principle

• A potentially life-saving procedure done to counteract effects of serious diseases by replacing patient blood

Uses

• Primarily used to counteract:
• Jaundice a result of an excess of bilirubin in body
• Sickle cell disease a group of blood disorders that cause crescent-shaped RBCs
• Dangerously high RBC count in newborns

Preperation

• http://www.healthline.com/health/exchange-transfusion

Procedure

• Blood is slowly withdrawn ( 5 to 20 mL at a time)
• A slightly larger amount of fresh, prewarmed blood/plasma flows into the patient's body. This cycle is repeated until the correct volume of blood has been replaced. After the exchange transfusion, catheters may be left in place in case the procedure needs to be repeated.
• Repeated in cycles until correct volume of blood has been replaced.
• Catheters may be left in place in case the procedure needs to be repeated.

Patients risk

• Changes in blood chemistry (high or low potassium, calcium, glucose)
• Heart and lung problems
• Infection
• Shock
• Blood clots

Risk cont.

• If one of these side effects occurs stop transfusion immediately.
• Pathologist will determine whether that specific transfusion can be resumed later.

Also at risk for

• Patient at risk of iron overload (too much iron accumulated in blood) if multiple blood transfusions occur over a relatively short period of time
• Chelation therapy used to remove the excess iron from body

Post transfusion

• Monitor patient for blood pressure, heart rate, and temperature. If all these readings are normal, the intravenous lines will be removed