The Combination of Blood Transfusion and Repositioning in Hemolytic Anemia Patients with Peripheral Perfusion Disorders: Case Report

Authors

  • Bill Ilham Mahardika Jati Program Profesi Ners, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia
  • Nita Fitria Departemen Keperawatan Dasar, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia
  • Mariah Komariah Departemen Keperawatan Dasar, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

DOI:

https://doi.org/10.36590/kepo.v6i2.1493

Keywords:

anemia, blood transfusion, mobilization

Abstract

One approach to restore hemoglobin levels was blood transfusion. Another approach to help prevent the risk of pressure ulcers was alternating the patient's position from right to left. This study aimed to describe the impact of blood transfusion and alternating right and left positioning in anemic patients with nursing problems of ineffective peripheral perfusion and risk of pressure ulcers. This study used a case report method. The sample was a male patient in an internal medicine ward. Data collection was conducted using observation, physical examination, and interviews. The patient's peripheral perfusion condition improved, accompanied by improvements in vital signs after the administration of 390 mL of PRC transfusion in two units. In addition, no damage to skin integrity was observed, and the Braden Score showed a change from 12 (high risk of pressure ulcers) to 15 (low risk) after repositioning the patient using a 90° lateral position every 1–2 hours for three days. The findings indicated that both therapies were effective in improving peripheral perfusion and reducing the risk of pressure ulcers.

Downloads

Download data is not yet available.

Author Biographies

Bill Ilham Mahardika Jati, Program Profesi Ners, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

Program Profesi Ners, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

Nita Fitria, Departemen Keperawatan Dasar, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

Departemen Keperawatan Dasar, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

https://scholar.google.com

Mariah Komariah, Departemen Keperawatan Dasar, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

Departemen Keperawatan Dasar, Fakultas Keperawatan, Universitas Padjadjaran, Bandung, Indonesia

https://scholar.google.com

References

Acker, J.P., Marks, D.C., Sheffield, W.P., 2016. Quality Assessment of Established and Emerging Blood Components for Transfusion. Journal of Blood Transfusion 2016(1), 1–28. https://doi.org/10.1155/2016/4860284

Aliyyah, L.N., Husain, F., 2024. Penerapan Mobilisasi Miring Kanan-Miring Kiri untuk Pencegahan Dekubitus pada Pasien Stroke. Nursing Applied Journal 2(4), 27–38. https://jurnal.stikeskesosi.ac.id/index.php/NAJ/article/view/363

Amelia, L., Saputra, R., Lestari, L., Puspita, D., Rahayu, I.D., Purnamawati, D.A., Almumtahanah, A., 2021. Perfusi Perifer Tidak Efektif (Anemia) pada An. A di Ruang Anak RSUD Dr. Soedarso Pontianak. Jurnal Ilmu Kesehatan 5(1), 1-8. https://doi.org/10.33757/jik.v5i1.307

Amer, A.C.A., Janah, E.N., Hediyanto, W., 2023. Asuhan Keperawatan pada Ny. S dengan Gangguan Sistem Hematologi: Anemia di Ruang Dahlia RSUD dr. Soeselo Kabupaten Tegal. Jurnal Medika Nusantara 1(4), 158-171. https://doi.org/10.59680/medika.v1i4.616

Armaidi, D., Irawan, R., 2015. Mengenal CPOB untuk Produk Darah. Jambi Medical Journal 3(2), 111–118. https://online-journal.unja.ac.id/kedokteran/article/view/3087

Berentsen, S., Sundic, T., 2015. Red Blood Cell Destruction in Autoimmune Hemolytic Anemia: Role of Complement and Potential New Targets for Therapy. BioMed Research International 1, 1-11. https://doi.org/10.1155/2015/363278

Blackburn, J., Ousey, K., Taylor, L., Moore, B., Patton, D., Moore, Z., Avsar, P., 2020. The Relationship between Common Risk Factors and The Pathology of Pressure Ulcer Development: A Systematic Review. Journal of Wound Care 29(3), S4–S12. https://doi.org/10.12968/jowc.2020.29.Sup3.S4

Coleman, S., Gorecki, C., Nelson, E.A., Closs, S.J., Defloor, T., Halfens, R., Farrin, A., Brown, J., Schoonhoven, L., Nixon, J., 2013. Patient Risk Factors for Pressure Ulcer Development: Systematic Review. International Journal of Nursing Studies 50(7), 974–1003. https://doi.org/10.1016/j.ijnurstu.2012.11.019

Dimauro, G., Griseta, M.E., Camporeale, M.G., Clemente, F., Guarini, A., Maglietta, R., 2023. An Intelligent Non-Invasive System for Automated Diagnosis of Anemia Exploiting a Novel Dataset. Artificial Intelligence in Medicine 136, 1-11. https://doi.org/10.1016/j.artmed.2022.102477

Fitri, D.D., Bahri, T.S., Kasih, L.C., 2022. Nursing Care for A Stage V Chronic Kidney Disease with Pleural Effusion Patient in The Internal Medicine Ward: Case Study. Jurnal Ilmiah Mahasiswa Fakultas Keperawatan 1(3), 1–8. https://garuda.kemdiktisaintek.go.id/documents/detail/3939716

Gardner, W.M., Razo, C., McHugh, T.A., Hagins, H., Tella, V.M., Hennessy, C., 2023. Prevalence, Years Lived with Disability, and Trends in Anaemia Burden by Severity and Cause, 1990–2021: Findings from the Global Burden of Disease Study 2021. Lancet Haematology 10(9), 713–734. https://doi.org/10.1016/S2352-3026(23)00160-6

Insani, N., Manggau, M.A., Kasim, H., 2018. Analisis Efektivitas Terapi pada Pasien Anemia Gagal Ginjal Hemodialisis di RSUP Dr. Wahidin Sudirohusodo Makassar. Majalah Farmasi dan Farmakologi 22(1), 13–15. https://doi.org/10.20956/mff.v22i1.5690

Janardhana, I.D.A.G.A., Ariwangsa, I.D.G.A.S., 2021. Anemia Defisiensi Besi pada Pasien dengan Ulkus Peptikum: Laporan Kasus. Intisari Sains Medis 12(1), 113–116.

Jaul, E., Barron, J., Rosenzweig, J.P., Menczel, J., 2018. An Overview of Co-Morbidities and The Development of Pressure Ulcers Among Older Adults. BMC Geriatrics 18(305), 1–11. https://doi.org/10.1186/s12877-018-0997-7

Jeon, Y.T., 2018. Avoiding Pressure Ulcers: Beyond Proper Positioning. Korean Journal of Anesthesiology 71(1), 1–2. https://doi.org/10.4097/kjae.2018.71.1.1

Mahajan, A., 2024. Management of Hypersplenism in Hemolytic Anemias. Pediatric Hematology Oncology Journal 9(4), 223–227. https://doi.org/10.1016/j.phoj.2024.07.004

Mantika, A.I., Mulyati, T., 2014. Hubungan Asupan Energi, Protein, Zat Besi dan Aktivitas Fisik dengan Kadar Hemoglobin Tenaga Kerja Wanita di Pabrik Pengolahan Rambut PT. Won Jin Indonesia. Journal of Nutrition College 3(4), 848–854. https://doi.org/10.14710/jnc.v3i4.6890

Mentari, D., Nugraha, G., 2023. Mengenal Anemia: Patofisiologi, Klasifikasi, dan Diagnosis. Penerbit BRIN, Jakarta Pusat.

Meriyani, H., Sartikawati, N.K.A., Putra, I.M.A.S., 2019. Pengaruh Penggunaan Antianemia terhadap Kadar Hemoglobin Pasien Gagal Ginjal Kronik. Jurnal Ilmiah Medicamento 5(2), 105–110. https://doi.org/10.36733/medicamento.v5i2.665

Muflikhah, N.D., Nuraini, F.R., Anggita, E.S., 2023. Produksi Komponen Darah Packed-Red Cell (PRC), Liquid Plasma (LP), Thombocytes Concentrates (TC) dan Fresh-Frozen-Plasma (FFP) di UDD PMI Kabupaten Bojonegoro. Jurnal Laboratorium Khatulistiwa 7(1), 58–63. https://ejournal.poltekkes-pontianak.ac.id/index.php/JLK/article/view/1163/0

Nadukkandiyil, N., Syamala, S., Saleh, H.A., Sathian, B., Ahmadi Zadeh, K., Acharath Valappil, S., Alobaidli, M., Elsayed, S.A., Abdelghany, A., Jayaraman, K., Al Hamad, H., 2020. Implementation of Pressure Ulcer Prevention and Management in Elderly Patients: A Retrospective Study in Tertiary Care Hospital in Qatar. Aging Male 23, 1066–1072. https://doi.org/10.1080/13685538.2019.1670156

Oktariani, S., Handaya, A.Y., Purwanto, I., 2020. Peningkatan Profil Klinik-Hematologi pada Pasien Sindrom Mielodisplasia Multilini Paska Splenektomi Total. Jurnal Penyakit Dalam Udayana 4(1), 1–4. https://doi.org/10.36216/jpd.v4i1.133

Putri, Y., 2014. Faktor Risiko Sepsis pada Pasien Dewasa di RSUP Dr. Kariadi. [Skripsi]. Universitas Diponegoro, Semarang.

Rahmat, E., Lee, J., Kang, Y., 2021. Javanese Turmeric (Curcuma xanthorrhiza Roxb.): Ethnobotany, Phytochemistry, Biotechnology, and Pharmacological Activities. Evidence-based Complementary and Alternative Medicine 2021(1), 1-15. https://doi.org/10.1155/2021/9960813

Rahmawati, R.D., Suparti, S., 2024. Screening Anemia pada Kelompok Wanita di Desa Cikidang. Binawan Student Journal 6(1), 80–87. https://doi.org/10.54771/ckjnr817

Sari, Y.K., Sari, E.A., Pratiwi, S.H., 2023. Hipervolemia dan Keletihan pada Pasien Chronic Kidney Disease Stage 5: Sebuah Studi Kasus. Malahayati Health Student Journal 3(9), 2605–2618. https://doi.org/10.33024/mahesa.v3i9.10878

Sepvianti, W., Widyaswara, G., Rahman, A., Zain, K.R., Tirtana, A., Pebriana, R., Kodo, J.A.L., 2023. Evaluasi Kualitas Packed Red Cell (PRC) berdasarkan Kadar pH Darah selama Masa Penyimpanan 36 Hari. Jurnal Kesehatan Rajawali 12(2), 31–34. https://doi.org/10.54350/jkr.v12i2.149

Setiawan, I., Susyanti, D., Pratama, M.Y., 2023. Penerapan Posisi Miring Kanan dan Miring Kiri (Ambulasi) terhadap Pencegahan Dekubitus pada Pasien Stroke Hemoragik. SCRIPTA SCORE Scientific Medical Journal 4(2), 78–82. https://doi.org/10.32734/scripta.v4i2.10511

Simamora, T.Y., Kristanti, F., Wibawa, S.R., 2023. Manajemen Luka Tekan pada Pasien Tirah Baring : Literature Review. Jurnal Keperawatan Klinis dan Komunitas 7(3), 155-164. https://doi.org/10.22146/jkkk.80144

Simanjuntak, T.R., Purnama, A., 2020. Efektivitas Mobilisasi Miring Kiri Miring Kanan dalam Upaya Pencegahan Pressure Injury pada Pasien Sepsis di Ruang Instalasi Pelayanan Intensif. Jurnal Keperawatan Komprehensif 6(1), 35–44. https://doi.org/10.33755/jkk.v6i1.160

Sree, V.D., Rausch, M.K., Tepole, A.B., 2019. Linking Microvascular Collapse to Tissue Hypoxia in A Multiscale Model of Pressure Ulcer Initiation. Biomechanics and Modeling in Mechanobiology 18, 1947–1964. https://doi.org/10.1007/s10237-019-01187-5

Turner, J., Parsi, M., Badireddy, M., 2023. Anemia, Health Technology Assessment. StatPearls Publishing, New York.

Tuz, M.A., Mitchell, M., 2021. The Influence of Anaemia on Pressure Ulcer Healing in Elderly Patients. British Journal of Nursing 30(15), 1-12. https://doi.org/10.12968/bjon.2021.30.15.S32

Wahidiyat, P.A., Adnani, N.B., 2017. Transfusi Rasional pada Anak. Sari Pediatri 18(4), 325-332. https://doi.org/10.14238/sp18.4.2016.325-31

[WHO] World Health Organization., 2024. Guideline on Haemoglobin Cutoffs to Define Anaemia in Individuals and Populations., World Health Organization, Geneva.

Zulqifni, F., Suandika, M., 2022. Pemberian Transfusi Darah sebagai Upaya Peningkatan Perfusi Jaringan pada Pasien Anemia. Jurnal Inovasi Penelitian 3(5), 6151–6156. https://garuda.kemdiktisaintek.go.id/documents/detail/3067029

Downloads

Published

2025-11-30

How to Cite

Jati, B. I. M., Fitria, N., & Komariah, M. (2025). The Combination of Blood Transfusion and Repositioning in Hemolytic Anemia Patients with Peripheral Perfusion Disorders: Case Report. Jurnal Keperawatan Profesional (KEPO), 6(2), 397–406. https://doi.org/10.36590/kepo.v6i2.1493