Challenges of Blood Transfusion Sets in Geriatric Care

I. Issues Regarding Blood Transfusion Set Materials and Particulate Filtration

1. Blood Transfusion Set Materials: Currently, 90% of domestically produced blood transfusion tubing and funnels are made of polyvinyl chloride (PVC). Their filtration pore sizes are relatively large, making them prone to clogging by micro-aggregates—such as platelets and white blood cells—thereby reducing the effective filtration area. Furthermore, PVC exhibits strong adsorption properties for certain alcohol-soluble and lipid-soluble drugs; this can lead to inaccurate dosing and compromise therapeutic efficacy.
2. Particulate Filtration: Infusion-related particulates typically range from 1 to 15 μm in diameter, with some reaching 50 to 300 μm. These particles can cause localized vascular occlusion, insufficient blood supply, and tissue hypoxia, and may even trigger adverse reactions such as phlebitis, edema, and granuloma formation. The filtration pore sizes in standard blood transfusion sets are unable to effectively filter out these particles, thereby increasing the risks faced by elderly patients during transfusion.

II. Special Physiological Conditions of Elderly Patients

1. Decline in Organ Function: Elderly individuals experience a decline in organ function and physiological changes, resulting in reduced tolerance to blood transfusion therapy. During the transfusion process, elderly patients are more susceptible to adverse reactions, such as fever, chills, palpitations, and fluctuations in blood pressure.
2. Compromised Immune Function: Elderly patients generally have lower immune function; blood transfusion can trigger immune responses, such as antibody reactions or angioedema. These reactions not only exacerbate the patient's condition but may also compromise the effectiveness of the transfusion.

III. Monitoring and Management of Adverse Transfusion Reactions

1. Monitoring Adverse Reactions: During the transfusion process, it is essential to closely monitor changes in the elderly patient's vital signs, such as heart rate, respiration, and blood pressure. If any abnormal reaction is detected, the transfusion must be stopped immediately, and appropriate measures taken.
2. Managing Adverse Reactions: Different management strategies are required for different types of adverse transfusion reactions, such as febrile reactions or allergic reactions.