transfusion risks and reactions Flashcards
(20 cards)
Consent for a blood transfusion
1) 1 in 100 fever or hives
2) 1 in 1.7-6.7 million HCV, HBV
3) 1 in 8 million HIV
most common cause of death from transfusions
1 in 100 TACO
1 in 10k TRALI
1 in 40k sepsis, anaphylaxis, wrong blood
DDx for a fever during or 4 hours post transfusion
1) AHTR -
2) Bacon
3) Febrile non hemolytic transfusion rxn
4) underlying illness
how do you check for hemolysis
- CBC
- LDH
- Bili
- hapto
Bacon most often occurs with
platelet transfusions
with a high spike in temperature you worry about
Acute hemolytic
or
Bacon
Ddx for urticaria post /during platelet transfusion
anaphylaxs/major allergic reaction
minor urticaria
other cause
the urticaria minor reaction can often be due to
something in plasma of donor
treating urticaria - minor reaction
diphenhydramine
SOB 30 minutes into transfusion
O2 sat drops to 86%
Ddx
- TACO
-TRALI
Major allergic transfusion rxn = should have hives - dyspnea unrelated
manifestation of TACO
HIGH BP
HIGH JVP
High HRT rate
management of TACO
- stop transfusion
- CXray
- oxygen and diuretics
Preventing TACO
1 unit at a time
over 3.5 hrs
give furosemide
What is TRALI
- non-cardiogenic pulmonary edema
Manifestation of TRALI
Dyspnea
hypoxia
fever
hypotension
Management of TRALI
stop transfusion assess - send products back to lab chest X ray - supportive care, oxygen fluids
preventing TRALI
use male plasma for transfusion
Define hypotension
> 30 mmHg drop in systolic or diastolic p
Ddx for hypotension in context of transfusion
- TRALI Anaphylaxis Bacon AHTR severe FNHTR bradykinin mediated (if recipient on ACEi)
checking for hemolysis
- decreased Hb
- increased Retics
- increased Bili
- increased lDH
decreased hapto
+ DAT
