10.17.18 Transfusion Flashcards
This reaction occurs immediately after transfusion up to 24 hours after
Acute Hemolytic Transfusion Reaction (AHTR)
Symptoms include fever, chills, hypotension, DIC, oozing from insertion line, hemoglobinuria, back pain
AHTR
How does acute hyemolytic transfusion reaction occur?
Patient makes antibodies against transfused RBC; get hemolysis
How do you treat AHTR?
- Fulid replacement
- Maintain BP
- Monitor BUN and creatinine
- Monitor fibrinogen, D-Dimer, PT, PTT
- Watch for DIC
How can you prevent AHTR?
Start transfusion slowly
Proper typing/screening
This reactin can occur 24-48 hours post-transfusion
Delayed Hemolytic Transfusion Reaction (DHTR)
Symptom of this rxn include
- Rapid drop in Hb
- Spherocytes
DHTR
How does DHTR occur?
Low titer antibodies below Ab screen sensitivity revs up production in presence of antigen
DHTR typically occurs against which antibodies?
Kidd, Duffy, Kell, and MNS
What is the treatment for DHTR?
None required
Symptoms of this rxn include
- Respiratory distress
- Tachpnea/Tachycardia
- Hypoxemia
- Headache
- Peripheral edema
- Hypertension
- Compromised cardiopulmonary status
Transfusion Associated Circulatory Overload (TACO)
How doe TACO occur?
Patient’s cardiopulmonary system exceeds its volume capacity
How do you treat TACO?
Administer O2 and diuretics
How do you prevent TACO>?
Transfuse at slow rate
This rxn can occur during or within 6 hours of transfusion
Transfusion Related Acute Lung Injury (TRALI)
Symptoms of this rxn include:
- Respiratory distress
- Tachpnea/Tachycardia
- Hypoxemia
- Bilateral diffuse pulmonary infiltrate on CXR
- Hypotension
- No pre-exisiting lung injury
Transfusion-Related Acute Lung Injury (TRALI)
How do you treat TRALI?
- Respiratory/pressor support
Symptoms of this rxn include:
- Fever
- Chills
- Nausea
- Vomiting
- Headache
- Back pain
Febrile nonhemolytic transfusion rxn
With this reaction you would see no visible hemolysis and a negative DAT
Febrile Nonhemolytic transfusion rxn
What is the treatment for febrile nonhemolytic transfusion rxn?
Antipyretics (Acetominophen)
How do you prevent febrile nonhemolytic transfusion rxn?
Pre-storage leukocyte reduction of blood products
This rxn occurs within 4 hours of transfuion
Allergic/Anaphylactic Transfusion Rxn
Symptoms of this rxn include
- Hives
- Itchy skin
- Maculopapular rash
- Flushing
- Edema
- Erythema
- Respiratory distress
- Hypotension
Allergic/Anaphylactic Transfusion Rxn
How do you treat Allergic/Anaphylactic Transfusion rxn?
Stop transfusion
Administer antihistamines
Once symptoms abated can continue transfusion safely
What is the most common transfusion-transmitted infection?
HBV
When would you give cryoprecipitate?
Deficiency of fibrinogen
When would you give plasma?
Coag factor deficiency
When would you give platelet
Thrombocytopenia; platelet dysfunction
When would you give RBC
- Symptoms of insufficient O2 carrying capacity
2. Rapid active bleeding
