SlideShare a Scribd company logo

Massive Blood Transfusion

•Download as PPT, PDF•
•
Saeed Al-Shomimi
Saeed Al-Shomimi
Health & MedicineBusiness
1 of 49
Massive Blood Transfusion Definition, Indications Complications Dr. Maha AL-Madi Urology Resident
[object Object],[object Object],[object Object],[object Object],[object Object],Objectives
Definition of MBT… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition of MBT… ,[object Object],[object Object],[object Object]
Definition of MBT… ,[object Object],[object Object]
General Indications … ,[object Object],[object Object]
General Indications …… ,[object Object],[object Object],[object Object],[object Object],[object Object]
General Indications …… ,[object Object],[object Object],[object Object]
General Indications … ,[object Object],[object Object],[object Object],[object Object],[object Object]
Indication for MBT … ,[object Object],[object Object],[object Object],[object Object],[object Object]
General Indications … ,[object Object],[object Object]
Clinical Practice Guidelines and Recommendations * Clinical practice guideline: RBC transfusion in adult trauma and critical care. Crit Care Med 2009 vol.37 No.12
Clinical practice guidelines..
Clinical practice guidelines..
Clinical practice guidelines..…
Clinical practice guidelines..
Clinical practice guidelines..
Benefits of BT ,[object Object],[object Object],[object Object]
Complications of BT… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of BT… Acute non-hemolytic rxns Hemolytic rxns TRALI GVHD 1.Hypersensitivity rxn 2.Febrile non hemolytic 1. Acute immune hemolysis 2. Delayed hemolysis Transfusion Rxns Infective Massive BT
Complications of BT… VIRAL CMV (1:10 to 1:30)  EBV (1:200) HBV ( 1 : 50,000) HCV (1 :3000-4000) HIV ( 1: 150,000) HTLV-I/ II(1:250,000 to 1:2 mill PARASITIC Malaria, (1:4 mill) BACTERIAL 1:200,000 to 1:4.8 mill Yersinia Serratia , Pseudomonas Enterobacter Transfusion Rxns Infective Massive BT
Complications of BT… Transfusion Rxns Infective Massive BT
Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object]
Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transfusion Reactions ,[object Object],[object Object]
Clinical practice guidelines.. ,[object Object]
Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of BT… ,[object Object],[object Object],[object Object]
Complications of BT… ,[object Object],[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of MBT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of MBT… ,[object Object],[object Object],[object Object]
Clinical Practice Guidelines. ,[object Object]
Clinical Practice Guidelines. ,[object Object]
 
Alternative to BT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Alternative to BT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
References.. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended

Massive transfusion
Massive transfusionMassive transfusion
Massive transfusion
Arthi Rajasankar
 
Massive transfusion
Massive transfusionMassive transfusion
Massive transfusion
KIMS
 
Massive transfusion protocol
Massive transfusion protocolMassive transfusion protocol
Massive transfusion protocol
DR SHADAB KAMAL
 
Transfusion related acute lung injury
Transfusion related acute lung injuryTransfusion related acute lung injury
Transfusion related acute lung injury
9857038254
 
Damage control resuscitation
Damage control resuscitationDamage control resuscitation
Damage control resuscitation
SCGH ED CME
 
Massive transfusion protocol
Massive transfusion protocolMassive transfusion protocol
Massive transfusion protocol
akshaya tomar
 
Assessment of blood loss
Assessment of blood loss Assessment of blood loss
Assessment of blood loss
Aboubakr Elnashar
 
Malignant Hyperthermia
Malignant HyperthermiaMalignant Hyperthermia
Malignant Hyperthermia
Shailendra Veerarajapura
 

Recommended

Massive transfusion
Massive transfusionMassive transfusion
Massive transfusion
Arthi Rajasankar
 
Massive transfusion
Massive transfusionMassive transfusion
Massive transfusion
KIMS
 
Massive transfusion protocol
Massive transfusion protocolMassive transfusion protocol
Massive transfusion protocol
DR SHADAB KAMAL
 
Transfusion related acute lung injury
Transfusion related acute lung injuryTransfusion related acute lung injury
Transfusion related acute lung injury
9857038254
 
Damage control resuscitation
Damage control resuscitationDamage control resuscitation
Damage control resuscitation
SCGH ED CME
 
Massive transfusion protocol
Massive transfusion protocolMassive transfusion protocol
Massive transfusion protocol
akshaya tomar
 
Assessment of blood loss
Assessment of blood loss Assessment of blood loss
Assessment of blood loss
Aboubakr Elnashar
 
Malignant Hyperthermia
Malignant HyperthermiaMalignant Hyperthermia
Malignant Hyperthermia
Shailendra Veerarajapura
 
Massive blood transfusion
Massive blood transfusionMassive blood transfusion
Massive blood transfusion
Aashissh Shah
 
Massive Transfusion Protocol + Blood transfusions
Massive Transfusion Protocol + Blood transfusionsMassive Transfusion Protocol + Blood transfusions
Massive Transfusion Protocol + Blood transfusions
David Hersey
 
Post dural puncture headache
Post dural puncture headachePost dural puncture headache
Post dural puncture headache
KIMS
 
TEG - Thromboelastography
TEG - ThromboelastographyTEG - Thromboelastography
TEG - Thromboelastography
Mohtasib Madaoo
 
Rapid sequence intubation
Rapid sequence intubationRapid sequence intubation
Rapid sequence intubation
Khairunnisa Azman
 
Massive blood transfusion
Massive blood transfusionMassive blood transfusion
Massive blood transfusion
salamon raja
 
#Blood loss estimation
#Blood loss estimation#Blood loss estimation
#Blood loss estimation
Nisar Arain
 
Perioperative fluid therapy
Perioperative fluid therapyPerioperative fluid therapy
Perioperative fluid therapy
anaesthesiology-mgmcri
 
Rapid Sequence Induction & Intubation
Rapid Sequence Induction & Intubation Rapid Sequence Induction & Intubation
Rapid Sequence Induction & Intubation
RamanGhimire3
 
Septic shock
Septic shockSeptic shock
Septic shock
Bashir BnYunus
 
Pre-oxygenation
Pre-oxygenationPre-oxygenation
Pre-oxygenation
SCGH ED CME
 
IV FLUID MANAGEMENT/ FLUID THERAPY
IV FLUID MANAGEMENT/ FLUID THERAPYIV FLUID MANAGEMENT/ FLUID THERAPY
IV FLUID MANAGEMENT/ FLUID THERAPY
Ashutosh Pakale
 
Blood transfusion in surgery
Blood transfusion in surgeryBlood transfusion in surgery
Blood transfusion in surgery
Drkabiru2012
 
Damage control resuscitation
Damage control resuscitationDamage control resuscitation
Damage control resuscitation
SCGH ED CME
 
Local anestheticst systemic toxicity
Local anestheticst systemic toxicityLocal anestheticst systemic toxicity
Local anestheticst systemic toxicity
ram krishna
 
COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA
COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIACOMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA
COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA
hanisahwarrior
 
Blood substitutes in therapy
Blood substitutes in therapyBlood substitutes in therapy
Blood substitutes in therapy
Dr Shahid Saache
 
Regional Anesthesia
Regional AnesthesiaRegional Anesthesia
Regional Anesthesia
meducationdotnet
 
Damage Control Resuscitation
Damage Control ResuscitationDamage Control Resuscitation
Damage Control Resuscitation
Sun Yai-Cheng
 
Intravenous fluids crystalloids and colloids
Intravenous fluids crystalloids and colloidsIntravenous fluids crystalloids and colloids
Intravenous fluids crystalloids and colloids
omar143
 
Complications of massive blood transfusion
Complications of massive blood transfusionComplications of massive blood transfusion
Complications of massive blood transfusion
KETAN VAGHOLKAR
 
Complications of blood transfusion
Complications of blood transfusionComplications of blood transfusion
Complications of blood transfusion
raj kumar
 

More Related Content

What's hot

Massive blood transfusion
Massive blood transfusionMassive blood transfusion
Massive blood transfusion
Aashissh Shah
 
Post dural puncture headache
Post dural puncture headachePost dural puncture headache
Post dural puncture headache
KIMS
 

What's hot (20)

Massive blood transfusion
Massive blood transfusionMassive blood transfusion
Massive blood transfusion
 
Massive Transfusion Protocol + Blood transfusions
Massive Transfusion Protocol + Blood transfusionsMassive Transfusion Protocol + Blood transfusions
Massive Transfusion Protocol + Blood transfusions
 
Post dural puncture headache
Post dural puncture headachePost dural puncture headache
Post dural puncture headache
 
TEG - Thromboelastography
TEG - ThromboelastographyTEG - Thromboelastography
TEG - Thromboelastography
 
Rapid sequence intubation
Rapid sequence intubationRapid sequence intubation
Rapid sequence intubation
 
Massive blood transfusion
Massive blood transfusionMassive blood transfusion
Massive blood transfusion
 
#Blood loss estimation
#Blood loss estimation#Blood loss estimation
#Blood loss estimation
 
Perioperative fluid therapy
Perioperative fluid therapyPerioperative fluid therapy
Perioperative fluid therapy
 
Rapid Sequence Induction & Intubation
Rapid Sequence Induction & Intubation Rapid Sequence Induction & Intubation
Rapid Sequence Induction & Intubation
 
Septic shock
Septic shockSeptic shock
Septic shock
 
Pre-oxygenation
Pre-oxygenationPre-oxygenation
Pre-oxygenation
 
IV FLUID MANAGEMENT/ FLUID THERAPY
IV FLUID MANAGEMENT/ FLUID THERAPYIV FLUID MANAGEMENT/ FLUID THERAPY
IV FLUID MANAGEMENT/ FLUID THERAPY
 
Blood transfusion in surgery
Blood transfusion in surgeryBlood transfusion in surgery
Blood transfusion in surgery
 
Damage control resuscitation
Damage control resuscitationDamage control resuscitation
Damage control resuscitation
 
Local anestheticst systemic toxicity
Local anestheticst systemic toxicityLocal anestheticst systemic toxicity
Local anestheticst systemic toxicity
 
COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA
COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIACOMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA
COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA
 
Blood substitutes in therapy
Blood substitutes in therapyBlood substitutes in therapy
Blood substitutes in therapy
 
Regional Anesthesia
Regional AnesthesiaRegional Anesthesia
Regional Anesthesia
 
Damage Control Resuscitation
Damage Control ResuscitationDamage Control Resuscitation
Damage Control Resuscitation
 
Intravenous fluids crystalloids and colloids
Intravenous fluids crystalloids and colloidsIntravenous fluids crystalloids and colloids
Intravenous fluids crystalloids and colloids
 

Viewers also liked

Complications of blood transfusion
Complications of blood transfusionComplications of blood transfusion
Complications of blood transfusion
raj kumar
 
Massive transfusion
Massive transfusionMassive transfusion
Massive transfusion
Rafiq Ahmad
 

Viewers also liked (6)

Complications of massive blood transfusion
Complications of massive blood transfusionComplications of massive blood transfusion
Complications of massive blood transfusion
 
Complications of blood transfusion
Complications of blood transfusionComplications of blood transfusion
Complications of blood transfusion
 
Chest Trauma
Chest Trauma Chest Trauma
Chest Trauma
 
Massive transfusion
Massive transfusionMassive transfusion
Massive transfusion
 
Management of massive blood loss
Management of massive blood lossManagement of massive blood loss
Management of massive blood loss
 
Massive Transfusion in Trauma
Massive Transfusion in TraumaMassive Transfusion in Trauma
Massive Transfusion in Trauma
 

Similar to Massive Blood Transfusion

Indications and complications of blood transfusion
Indications and complications of blood transfusion Indications and complications of blood transfusion
Indications and complications of blood transfusion
abhimanyu_ganguly
 
L 32 complications of blood transfusion
L 32 complications of blood transfusionL 32 complications of blood transfusion
L 32 complications of blood transfusion
Bruno Mmassy
 
L 32 complications of blood transfusion
L 32 complications of blood transfusionL 32 complications of blood transfusion
L 32 complications of blood transfusion
Fiba Farooq
 
Blood Transfusion
Blood Transfusion Blood Transfusion
Blood Transfusion
Khalid
 
Hemostasis, surgical bleeding and transfusion
Hemostasis, surgical bleeding and transfusionHemostasis, surgical bleeding and transfusion
Hemostasis, surgical bleeding and transfusion
Mae Martinquilla
 

Similar to Massive Blood Transfusion (20)

Anemia defibtion introduction management.pptx
Anemia defibtion introduction management.pptxAnemia defibtion introduction management.pptx
Anemia defibtion introduction management.pptx
 
Myeloproliferative Disorders Other Than CML
Myeloproliferative Disorders Other Than CMLMyeloproliferative Disorders Other Than CML
Myeloproliferative Disorders Other Than CML
 
Bl.therapy2012
Bl.therapy2012Bl.therapy2012
Bl.therapy2012
 
Physiological triggers for blood transfusion in the icu
Physiological triggers for blood transfusion in the icuPhysiological triggers for blood transfusion in the icu
Physiological triggers for blood transfusion in the icu
 
renaltransplant.ppt.pptx
renaltransplant.ppt.pptxrenaltransplant.ppt.pptx
renaltransplant.ppt.pptx
 
Indications and complications of blood transfusion
Indications and complications of blood transfusion Indications and complications of blood transfusion
Indications and complications of blood transfusion
 
Blood Transfusion
Blood TransfusionBlood Transfusion
Blood Transfusion
 
Rational use of Blood.pptx
Rational use of Blood.pptxRational use of Blood.pptx
Rational use of Blood.pptx
 
massive transfusion.pptx
massive transfusion.pptxmassive transfusion.pptx
massive transfusion.pptx
 
uproach to anemia in ICU
uproach to anemia in ICUuproach to anemia in ICU
uproach to anemia in ICU
 
L 32 complications of blood transfusion
L 32 complications of blood transfusionL 32 complications of blood transfusion
L 32 complications of blood transfusion
 
L 32 complications of blood transfusion
L 32 complications of blood transfusionL 32 complications of blood transfusion
L 32 complications of blood transfusion
 
Part 4 clinical laboratory data
Part 4 clinical laboratory dataPart 4 clinical laboratory data
Part 4 clinical laboratory data
 
blood substitute blood.pptx
blood substitute blood.pptxblood substitute blood.pptx
blood substitute blood.pptx
 
Blood Transfusion
Blood Transfusion Blood Transfusion
Blood Transfusion
 
Part 4 laboratory values 2211
Part 4 laboratory values 2211Part 4 laboratory values 2211
Part 4 laboratory values 2211
 
A case of Upper GI Bleeding.pptx
A case of Upper GI Bleeding.pptxA case of Upper GI Bleeding.pptx
A case of Upper GI Bleeding.pptx
 
Hemostasis, surgical bleeding and transfusion
Hemostasis, surgical bleeding and transfusionHemostasis, surgical bleeding and transfusion
Hemostasis, surgical bleeding and transfusion
 
Blood transfusion (2)
Blood transfusion (2)Blood transfusion (2)
Blood transfusion (2)
 
Rational use of Blood.pptx
Rational use of Blood.pptxRational use of Blood.pptx
Rational use of Blood.pptx
 

More from Saeed Al-Shomimi

Can we apply the same indications of ESD for primary gastric cancer to remnan...
Can we apply the same indications of ESD for primary gastric cancer to remnan...Can we apply the same indications of ESD for primary gastric cancer to remnan...
Can we apply the same indications of ESD for primary gastric cancer to remnan...
Saeed Al-Shomimi
 
Retroperitoneal Collections
Retroperitoneal CollectionsRetroperitoneal Collections
Retroperitoneal Collections
Saeed Al-Shomimi
 
How to do - Abdominal Trauma
How to do - Abdominal TraumaHow to do - Abdominal Trauma
How to do - Abdominal Trauma
Saeed Al-Shomimi
 
Breast Cancer during pregnancy
Breast Cancer during pregnancyBreast Cancer during pregnancy
Breast Cancer during pregnancy
Saeed Al-Shomimi
 
Antibiotic prophylaxis in sever Acute Panceriatitis
Antibiotic prophylaxis in sever Acute PanceriatitisAntibiotic prophylaxis in sever Acute Panceriatitis
Antibiotic prophylaxis in sever Acute Panceriatitis
Saeed Al-Shomimi
 
Esophaegeal resection & reconstruction
Esophaegeal resection & reconstructionEsophaegeal resection & reconstruction
Esophaegeal resection & reconstruction
Saeed Al-Shomimi
 
A v fistula in heamodialysis
A v fistula in heamodialysisA v fistula in heamodialysis
A v fistula in heamodialysis
Saeed Al-Shomimi
 
Lower Limb Vascular Trauma
Lower Limb Vascular TraumaLower Limb Vascular Trauma
Lower Limb Vascular Trauma
Saeed Al-Shomimi
 
Risk Factors of Breast Cancer
Risk Factors of Breast CancerRisk Factors of Breast Cancer
Risk Factors of Breast Cancer
Saeed Al-Shomimi
 
Surgical Management in Ulcerative Colitis
Surgical Management in Ulcerative ColitisSurgical Management in Ulcerative Colitis
Surgical Management in Ulcerative Colitis
Saeed Al-Shomimi
 
Endocrine Tumors Of The Pancreas
Endocrine Tumors Of The PancreasEndocrine Tumors Of The Pancreas
Endocrine Tumors Of The Pancreas
Saeed Al-Shomimi
 

More from Saeed Al-Shomimi (20)

Pathophysiology of wound healing
Pathophysiology of wound healingPathophysiology of wound healing
Pathophysiology of wound healing
 
Can we apply the same indications of ESD for primary gastric cancer to remnan...
Can we apply the same indications of ESD for primary gastric cancer to remnan...Can we apply the same indications of ESD for primary gastric cancer to remnan...
Can we apply the same indications of ESD for primary gastric cancer to remnan...
 
Retroperitoneal Collections
Retroperitoneal CollectionsRetroperitoneal Collections
Retroperitoneal Collections
 
Tube thoracostomy
Tube thoracostomyTube thoracostomy
Tube thoracostomy
 
How to do - Abdominal Trauma
How to do - Abdominal TraumaHow to do - Abdominal Trauma
How to do - Abdominal Trauma
 
Breast Cancer during pregnancy
Breast Cancer during pregnancyBreast Cancer during pregnancy
Breast Cancer during pregnancy
 
Antibiotic prophylaxis in sever Acute Panceriatitis
Antibiotic prophylaxis in sever Acute PanceriatitisAntibiotic prophylaxis in sever Acute Panceriatitis
Antibiotic prophylaxis in sever Acute Panceriatitis
 
Gallstone
GallstoneGallstone
Gallstone
 
Esophaegeal resection & reconstruction
Esophaegeal resection & reconstructionEsophaegeal resection & reconstruction
Esophaegeal resection & reconstruction
 
A v fistula in heamodialysis
A v fistula in heamodialysisA v fistula in heamodialysis
A v fistula in heamodialysis
 
DVT Current Concept
DVT Current ConceptDVT Current Concept
DVT Current Concept
 
Diabetic Foot Examination
Diabetic Foot ExaminationDiabetic Foot Examination
Diabetic Foot Examination
 
Solitary Thyroid Nodule
Solitary Thyroid NoduleSolitary Thyroid Nodule
Solitary Thyroid Nodule
 
Lower Limb Vascular Trauma
Lower Limb Vascular TraumaLower Limb Vascular Trauma
Lower Limb Vascular Trauma
 
Risk Factors of Breast Cancer
Risk Factors of Breast CancerRisk Factors of Breast Cancer
Risk Factors of Breast Cancer
 
Liver Trauma
Liver TraumaLiver Trauma
Liver Trauma
 
Surgical Management in Ulcerative Colitis
Surgical Management in Ulcerative ColitisSurgical Management in Ulcerative Colitis
Surgical Management in Ulcerative Colitis
 
Endocrine Tumors Of The Pancreas
Endocrine Tumors Of The PancreasEndocrine Tumors Of The Pancreas
Endocrine Tumors Of The Pancreas
 
Ischemic Colitis
Ischemic ColitisIschemic Colitis
Ischemic Colitis
 
Gastric Carcinoma
Gastric CarcinomaGastric Carcinoma
Gastric Carcinoma
 

Recently uploaded

Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
vidya singh
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
karishmasinghjnh
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
parulsinha
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
perfect solution
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
parulsinha
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
chandars293
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Anamika Rawat
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
adilkhan87451
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
GENUINE ESCORT AGENCY
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Namrata Singh
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
parulsinha
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Anamika Rawat
 
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Dipal Arora
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Call Girls Delhi
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
BhumiSaxena1
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
GENUINE ESCORT AGENCY
 

Recently uploaded (20)

Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
 
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 

Massive Blood Transfusion