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Transfusion Reactions > Transfusion reactions > Flashcards

Transfusion reactions Flashcards

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Organic Chemistry 101 flashcards
1
Q 
Onset as soon as transfusion starts
Fever
Flushing
Incr. HR
Hypotension
Severe chest and abdominal pain
A

Acute haemolytic transfusion reaction

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2
Q

Onset = minutes after transfusion starts
Urticarial rash
Itch

A

Allergic Reaction - Mild

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3
Q
  • Onset minutes after transfusion starts
  • Hypotension
  • Mucosal swelling
  • Airway obstruction: stridor, ↓O2 sats
A

Anaphylaxis Reaction - Severe

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4
Q
  • Rapid onset (but not minutes)
  • Fever
  • Rigors
  • Hypotension

Blood clots in bag

A

Bacterial infection

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5
Q
  • Onset = 30 minutes after starting
  • Fever
  • Rigors
A

Febrile, non-haemolytic reaction

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6
Q

• Onset = 6 hours
Prev. fit and well patient, who develops:
• Shortness of breath
• ↑ RR
• Bilateral crepitations
• CXR = pulmonary infiltrates/white out
• Pulmonary oedema w/ normal wedge pressure

A

Transfusion-Related Acute Lung Injury (TRALI

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7
Q
  • SOB + ↓ O2 sats
  • Bibasal crepitations
  • Tachycardia
  • ↑ JVP
A

Transfusion Associated Circulatory Overload – TACO

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8
Q
  • Onset = 5 – 10 days after transfusion
  • Jaundice
  • Sudden ↓ in Hb
  • AKI
  • Less severe form of acute haemolytic reaction
A

Delayed Haemolytic Reaction

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9
Q

What is an Acute Haemolytic Transfusion Reaction?

A

ABO blood group incompatibility
Recipient IgM Abs  donor RBCs

= significant intravascular haemolysis

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10
Q

What is a mild allergic reaction?

A

Type 1 hypersensitivity reaction  donor plasma proteins

IgE-mediated

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11
Q

What is an anaphylaxis transfusion reaction?

A

Severe Type 1 hypersensitivity reaction

More common in thos w/ IgA deficiency

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12
Q

What is a febrile transfusion reaction?

A

Recipient develop Abs  HLA on donor WBCs
(WBCs make cytokines while in storage – released into circulation at transfusion)

Recipient will have had previous transfusion

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13
Q

What is a Transfusion-Related Acute Lung Injury (TRALI)?

A

ARDS caused by anti-leucocyte Abs in transfused plasma (donor NOT recipient)
Causes Hypoxia

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14
Q

What is a Transfusion Associated Circulatory Overload – TACO?

A

Fluid overload

Usually seen in the elderly or those with CHF

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15
Q

What is a Delayed Haemolytic Reaction?

A

Due to reaction to irregular Abs in transfused blood

M. common in patients w/ previous transfusion

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16
Q

AHTR management

A
  1. STOP transfusion
  2. Fluid resuscitation
  3. Check patient + bag identity
  4. Bloods
  5. Check urine: haemoglobinuria
  6. Contact haematology and send blood back to lab
17
Q

Mild allergic reaction management:

A
  1. Slow or stopping reaction
  2. Supportive care: Oxygen/IV Fluids
  3. IV antihistamine: Chlorphenamine 10mg
  4. Close monitoring
18
Q

Anaphylaxis transfusion reaction management:

A
  1. STOP transfusion
  2. ABCDE: Oxygen + fluid challenge
  3. Adrenaline: 0.5 mL 1:1000 IM
  4. Hydrocortisone: 200 mg IV
  5. Chlorphenamine: 10 mg IV
  6. Get anaesthetist
19
Q

Bacterial infection management:

A
  1. STOP transfusion
  2. Fluid resuscitation
  3. Check patient bag + identity
  4. Bloods: Cultures, FBC, haptoglobin
  5. Check urine: haemoglobinuria
  6. Broad spectrum Abx
  7. Contact haematology + send blood back to lab
20
Q

Febrile reaction management:

A
  1. Slow or stop transfusion
  2. Anti-Pyretic = paracetamol
  3. Close monitoring

IF recurrent: leucodepleted transfusions

21
Q

TRALI managment:

A
  1. STOP the transfusion
  2. Oxygen
  3. Arrange ITU admission
  4. Source needs to be identified and donor removed from register
22
Q

TACO management:

A
  1. Slow or stop transfusion
  2. Oxygen
  3. IV Furosemide
23
Q

Delayed haemolytic reaction management:

A
  1. Supportive care: AKI/Clotting defects
  2. Screen patients’ blood for irregular Abs
  3. Ab reference card: identifies patient as having abnormal Abs

Transfusion Reactions (1 decks)

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