Blood Transfusion Adverse Reactions Flashcards
Dilutional Coagulopathy
Clotting factors are diluted due to RBC administration which lacks PLTs or coagulation factors
Citrate toxicity
Citrate accumulation due to citrate binding to calcium leading to hypocalcemia and associated complications.
Hyperkalemia
Potassium released from RBCs after prolonged storage. Therefore use freshest blood possible - in theory not practiced.
Viral
Viral transmission through transfusion, inadequate testing; donor questionnaire to eliminate high risk situations
Iron overload
Iron accumulation in storage sites with long-term transfusions
Hypothermia
Multiple unites of RBCs given can cause low body temperature. Warm blood products if several units given over a short period of time.
TACO (Transfusion Associated Circulatory Overload)
Impaired cardiac function or excessively rapid infusion
SOB, rapid breathing or cough
Fatal with 4-6 hr onset
Non-Immune hemolysis of RBC
Heating blood too hot, mixing solutions other than NaCL, using small bore needle
Decreased HCT
Mild. Use appropiate needle size and do not add anything other than saline to blood products.
Febrile Nonhemolytic Transfusion Reaction
Patient antibodies react against donor WBC
Temperature rise and chills
Mild with 4 hours onset. Give antipyretics.
Acute Haemolytic Reaction
Binding of antibodies present sufficient concentration to cause immediate hemolysis of donor cells
Fever, flank pain, low blood pressure, renal failure and difficulty breathing
Potentially fatal with onset occuring at anytime. Stop transfusion.
Post Transfusion Pupura
Patient anti-PLT antibodies remove donor and patient PLTs results in thrombocytopenia
Low platelet count and bleeding
Potentially fatal, occuring in 5-10 days. Give IV immunoglobulins
Allergic
Patient antibodies againt plasma proteins
Rash, itching, and hives
Treat with antihistamines
Anaphylactic
Patient antibodies against donor IgA molecules
Flushed skin, itching, hives, difficulty breathing, wheezing, blue lips, vomiting, low blood pressure
Potentially fatal. Give IgA deficient plasma and washed RBC
Graft vs Host
Donor immunocompent lymphocyte attack the patient’s tissue
Rash, abd pain, nausea, fever, bone marrow failure
2 days - 6 weeks after transfusion. Irradiated blood products
Transfusion Related Acute Lung Injury (TRALI)
Donor HLA antibodies attack patient WBC which then infiltrates the lung capillaries
Difficulty breathing, fever and high blood pressure
Potentially fatal with 6 hour onset. Treat lung injury with resp support.
