Transfusion reactions Flashcards
What are the main classifications of blood transfusion reactions?
Immunological: acute haemolytic, non-haemolytic febrile, allergic/anaphylaxis
Infective
Transfusion related lung injury
Transfusion related circulatory overload (TACO)
What are the feautres and management of a non-haemolytic febrile reaction to transfusion?
Thought to be due to antibodies reacting with white cell fragments and cytokines released during storage
Causes fever and chills
Treated by stopping transfusion, paracetamol and monitoring
What are the features and management of a minor allergic reaction to transfusion?
Thought to be due to foreign plasma proteins
Causes pruritis and urticaria
Treated by temporarily stopping transfusion, Antihistamine and monitoring
What are the features and management of anaphylactic reaction to transfusion?
Due to individuals with IgA deficiency having anti-IgA antibodies
Causes hypotension, wheezing, dyspnoea and angioedema
Treated with IM adrenaline, ABC support, oxygen and fluids
What are the features and management of an acute haemolytic reaction to blood transfusion?
If a patient is given ABO incompatible blood
Features are fever, abdo pain, hypotension
Treated by stopping transfusion, check blood type, send blood for direct coombs testing and supportive care with fluid resus
What are the features and management of transfusion assocaited circulation overload (TACO)?
Caused by excessive rate of transfusion or heart failure
Causes pulmonary oedema and hypertension
Treat by stopping transfusion and consider IV loop diuretic
What are the features and management of transfusion related acute lung injury (TRALI)
Non-cardiogenic pulmonary oedema thought to be secondary to increased vascular permeability caused by host neutrophils that become activated by substances in donated blood
Causes hypoxia, pulmonary infiltrates on CXR, fever and hypotension
Treated by stopping tranfusion, oxygen and supportive care
