10.17.18 Transfusion

Question 1

This reaction occurs immediately after transfusion up to 24 hours after

Answer 1

Acute Hemolytic Transfusion Reaction (AHTR)

Question 2

Symptoms include fever, chills, hypotension, DIC, oozing from insertion line, hemoglobinuria, back pain

Answer 2

AHTR

Question 3

How does acute hyemolytic transfusion reaction occur?

Answer 3

Patient makes antibodies against transfused RBC; get hemolysis

Question 4

How do you treat AHTR?

Answer 4

1. Fulid replacement
2. Maintain BP
3. Monitor BUN and creatinine
4. Monitor fibrinogen, D-Dimer, PT, PTT
5. Watch for DIC

Question 5

How can you prevent AHTR?

Answer 5

Start transfusion slowly

Proper typing/screening

Question 6

This reactin can occur 24-48 hours post-transfusion

Answer 6

Delayed Hemolytic Transfusion Reaction (DHTR)

Question 7

Symptom of this rxn include

1. Rapid drop in Hb
2. Spherocytes

Answer 7

DHTR

Question 8

How does DHTR occur?

Answer 8

Low titer antibodies below Ab screen sensitivity revs up production in presence of antigen

Question 9

DHTR typically occurs against which antibodies?

Answer 9

Kidd, Duffy, Kell, and MNS

Question 10

What is the treatment for DHTR?

Answer 10

None required

Question 11

Symptoms of this rxn include

1. Respiratory distress
2. Tachpnea/Tachycardia
3. Hypoxemia
4. Headache
5. Peripheral edema
6. Hypertension
7. Compromised cardiopulmonary status

Answer 11

Transfusion Associated Circulatory Overload (TACO)

Question 12

How doe TACO occur?

Answer 12

Patient’s cardiopulmonary system exceeds its volume capacity

Question 13

How do you treat TACO?

Answer 13

Administer O2 and diuretics

Question 14

How do you prevent TACO>?

Answer 14

Transfuse at slow rate

Question 15

This rxn can occur during or within 6 hours of transfusion

Answer 15

Transfusion Related Acute Lung Injury (TRALI)

Question 16

Symptoms of this rxn include:

1. Respiratory distress
2. Tachpnea/Tachycardia
3. Hypoxemia
4. Bilateral diffuse pulmonary infiltrate on CXR
5. Hypotension
6. No pre-exisiting lung injury

Answer 16

Transfusion-Related Acute Lung Injury (TRALI)

Question 17

How do you treat TRALI?

Answer 17

1. Respiratory/pressor support

Question 18

Symptoms of this rxn include:

1. Fever
2. Chills
3. Nausea
4. Vomiting
5. Headache
6. Back pain

Answer 18

Febrile nonhemolytic transfusion rxn

Question 19

With this reaction you would see no visible hemolysis and a negative DAT

Answer 19

Febrile Nonhemolytic transfusion rxn

Question 20

What is the treatment for febrile nonhemolytic transfusion rxn?

Answer 20

Antipyretics (Acetominophen)

Question 21

How do you prevent febrile nonhemolytic transfusion rxn?

Answer 21

Pre-storage leukocyte reduction of blood products

Question 22

This rxn occurs within 4 hours of transfuion

Answer 22

Allergic/Anaphylactic Transfusion Rxn

Question 23

Symptoms of this rxn include

1. Hives
2. Itchy skin
3. Maculopapular rash
4. Flushing
5. Edema
6. Erythema
7. Respiratory distress
8. Hypotension

Answer 23

Allergic/Anaphylactic Transfusion Rxn

Question 24

How do you treat Allergic/Anaphylactic Transfusion rxn?

Answer 24

Stop transfusion

Administer antihistamines

Once symptoms abated can continue transfusion safely

Question 25

What is the most common transfusion-transmitted infection?

Answer 25

HBV

Question 26

When would you give cryoprecipitate?

Answer 26

Deficiency of fibrinogen

Question 27

When would you give plasma?

Answer 27

Coag factor deficiency

Question 28

When would you give platelet

Answer 28

Thrombocytopenia; platelet dysfunction

Question 29

When would you give RBC

Answer 29

1. Symptoms of insufficient O2 carrying capacity

2. Rapid active bleeding