Exam 4 - Complications of Transfusions Flashcards
why are transfusion rates started slow?
hemolytic reactions are most likely to occur early on in the transfusion
T/F: non-hemolytic reactions are most likely to occur at the beginning of a transfusion
false - most likely to occur at the end
what monitoring should be done during a blood transfusion?
obtain baseline numbers before starting
HH, RR, temperature every 10 minutes for the first 30 minutes & then every hour until the transfusion is done
T/F: refrigerated blood products that have been open for more than 24 hours are at an increased risk of bacterial contamination
true
T/F: room temperature blood products that have been open for more than 6 hours are at an increased risk of bacterial contamination
true
what is the mortality of blood transfusions in patients receiving them?
39-53% - usually due to underlying disease
what are the general clinical signs associated with transfusion reactions?
non-specific, tachycardia, tachypnea, evaluate serum & urine for hemolysis, & rapid resolution of signs typically indicate less severe reactions
what is the most common transfusion reaction?
febrile, non-hemolytic reaction - increase in 1 C from baseline temperature
what is a febrile, non-hemolytic reaction associated with?
response to protein, leukocytes, or platelets in plasma protein
plasma products!!!!
T/F: a febrile, non-hemolytic reaction is possible with any transfusion product
true
what is the treatment for a febrile, non-hemolytic transfusion reaction?
stop the transfusion immediately - restart it in 20-30 minutes at a slower rate
what is an allergic, type I hypersensitivity reaction?
uncommon reaction - animal has urticaria, wheals, flares, & facial swelling
what is the treatment for an allergic, type I hypersensitivity reaction?
diphenhydramine at 1-4mg/kg SQ or IM - stop the transfusion, but you can typically resume at a slower rate with resolution of signs
what is an anaphylactic, type I hypersensitivity reaction?
acute onset of integumentary, gi, or respiratory signs without hypotension following exposure to an antigen
what is the treatment for an anaphylactic, type I hypersensitivity reaction?
epinephrine 0.01 mg/kg IV or IM - stop transfusion & DO NOT RESUME
what is the second most common transfusion reaction?
type II hypersensitivity
T/F: type II hypersensitivity reactions can be hard to identify in patients with IMHA
what causes acute hemolysis from a type II hypersensitivity reaction? what is the treatment recommended?
happens due to preformed antibodies to RBC surface antigens - most commonly DEA 1.1
immediately life threatening - stop transfusion & cross match before the next transfusion
what causes delayed hemolysis from a type II hypersensitivity reaction? what is the treatment recommended?
induction of antibody production typically to other blood groups in which the patient may or may not have clinical signs - supportive care
what is TRALI?
transfusion associated acute lung injury
what is the treatment for TRALI?
largely supportive care - supplemental O2
single dose of furosemide may be beneficial - issue with widespread inflammation & leaky capillaries, not a hydrostatic problem
what patients are at a greater risk for TACO?
patients with pre-existing cardiac disease, cats
also greater risk with plasma products due to colloid effects
what is the treatment for TACO?
furosemide trial & oxygen therapy
what is TACO?
transfusion associated circulatory overload