What Is a Transfusion Reaction?

Blood transfusion reaction refers to the adverse reaction caused by blood transfusion or its products or infusion equipment used during or after the blood transfusion. It is recommended that patients with a history of allergies can take antihistamines or corticosteroids orally half an hour before transfusion of blood products; choose suppliers without a history of allergies, and those with repeated allergic reactions can choose to wash red blood cells or frozen red blood cells, wash platelets, and disable plasma And plasma products, the removal of white blood cells or micropolymers does not prevent allergic reactions, because plasma proteins can pass through the filter.

Basic Information

Also known as

Adverse blood transfusion reactions

English name

transfusionreaction

Visiting department

Hematology

Common causes

Due to blood transfusion or product or infusion set used

Common symptoms

Urticaria, angioedema, arthralgia, chest tightness, shortness of breath, dyspnea, hypotension shock, chills, fever, etc.

Contagious

no

Transfusion reaction allergic reaction and treatment

Allergic reaction

Allergic reactions include: urticaria, angioedema, arthralgia, chest tightness, shortness of breath, dyspnea, and hypotension shock. One or more of them were diagnosed as allergic reactions. Once the above reaction occurs, the blood transfusion rate should be slowed down immediately. Dexamethasone should be given into the pot, phenagen intramuscular injection. In severe cases, the blood transfusion should be stopped immediately, and 1/1000 of epinephrine subcutaneous injection should be given. All patients were treated effectively.

2. Non-hemolytic fever reaction

After a blood transfusion, chills and fever occur shortly or during the blood transfusion. The temperature of the fever can reach 38 ° C to 41 ° C. The patients all have nausea, vomiting, and skin flushing. The reaction lasts for 1 to 2 hours, and then sweats and fevers. The level of fever is directly proportional to the white blood cell count and heat source input of the blood transfusion speed meter, and sometimes it can only respond a few hours after the blood transfusion. When the reaction occurs, blood transfusion should be stopped immediately and the condition closely monitored. Warm and sedatives are given during cold wars, and antipyretics can be used when fever is present.

3. Purpura after blood transfusion

All of them developed symptoms about 7 days after blood transfusion, and the onset was sharp, with obvious chills, high fever, urticaria, headache, chest pain, and difficulty breathing. There are bleeding in different parts, extensive skin spots and ecchymosis, bleeding gums, nosebleeds, and black stools; all are accompanied by thrombocytopenia. Patients have antiplatelet antibody IgG in the plasma and serum, and bone marrow cell blood tests are performed. Megakaryocytes increased, and the indirect anti-human globulin test was positive. Give a strong point of methylprednisolone, and immunoglobulin.

4. Graft-versus-host disease

Fever, skin flushing, rash, severe diarrhea, hepatosplenomegaly, etc. The highest body temperature reached 40 ° C, methotrexate was given at a fixed point, cyclosporine and prednisone were given orally. Review blood routine and transaminase until normal.

5. Transfusion hemochromatosis

Clinically, skin pigmentation, liver damage, diabetes, arrhythmia, cardiac insufficiency, and sexual dysfunction occur. Clinically, fresh red blood cells were transfused, and symptoms improved after oral iron removal.

6. Post-transfusion reaction

(1) Congestive heart failure and pulmonary edema are mainly manifested in: during or 1 hour after blood transfusion, rapid heart rate, shortness of breath, headache, head swelling, cough, white phlegm cough first, cough pink foam sputum later, neck Venous irritation, etc., severe cases die in a short period of time. If there is an appeal symptom, the blood transfusion should be stopped immediately. The patient should be placed in a semi-recumbent position with his legs drooping to reduce venous return and reduce the burden on the heart. Alcohol moisturizes oxygen, reduces the surface tension of the foam in the alveoli, and causes the foam to burst and dissipate, thereby improving lung gas exchange and reducing the symptoms of hypoxia, and giving sedative, vasodilator, cardiotonic, and diuretic drugs according to the doctor's advice. If necessary, ligate the limbs alternately. In addition, for patients without anemia, the amount of venous return to the heart can be reduced by venous bleeding of 200 to 300 ml.

(2) Patients with sodium citrate poisoning may experience muscle tremor, hand and foot twitching; severe patients with blood pressure drop, bleeding, ventricular fibrillation, etc. Treatment can be intravenously injected with 10% calcium gluconate or calcium chloride 10ml. Large amounts of rapid blood transfusion should also pay attention to hyperkalemia.

(3) Bleeding, such as bleeding from wounds, continuous bleeding, skin ecchymosis, and even gastrointestinal bleeding, should be measured platelet count, prothrombin time, fibrinogen measurement, and supplement according to the patient's platelet and coagulation factor deficiency Coagulation factors and platelets, in order to prevent blood clotting abnormalities that may be caused by a large amount of blood transfusion, fresher blood stored for 5 days can be transfused, or fresh blood or platelet suspension can be input according to the doctor's order.

(4) Microvascular embolism Because white blood cells and platelets can form tiny clots after the blood is stored for one week, when a large amount of this blood is transfused, a large number of tiny clots circulate to the lungs, blocking pulmonary capillaries and causing pulmonary insufficiency. If it is used for cardiac surgery for extracorporeal circulation, microcoagulation can directly cause cerebral embolism. Therefore, when a large amount of blood is transfused, blood within 5 days or a microporous filter can be used.

(5) Low-temperature response Due to the rapid and massive input of cold blood taken from the freezer, if the input volume reaches 1 liter every 5 minutes, the normal body temperature will drop below 30 ° C, and ventricular fibrillation may occur. In general, rescue blood transfusion does not need to reach the above-mentioned level, if it is really needed, it is advisable to infuse after a little warming.

(6) The degree of bacterial contamination reaction varies according to the type of bacteria, the amount of blood transfusion and the resistance of the recipient. In severe cases, toxic shock, DIC, acute renal failure, etc. may occur, and the mortality rate is high. Once such reactions are found, stop transfusion immediately and inform the doctor. The remaining blood and patient blood samples are sent to the laboratory for examination, blood culture and drug sensitivity tests. Those with high fever are treated as patients with high fever.

(7) Hemolytic reaction: Heterotype blood is input, which causes intravascular hemolysis. Generally, 10 15ml can produce symptoms. If a hemolytic reaction occurs, stop transfusion immediately and contact the doctor, and retain the remaining blood. Collect blood samples from patients and redo blood group identification and cross-matching tests to comfort patients to relieve their fear and anxiety; maintain intravenous fluids for administration during rescue; oral or intravenous drip of sodium bicarbonate to alkalinize urine; double The side waist is closed, and bilateral kidney areas are covered with hot water bags to prevent renal vasospasm and protect the kidneys; closely observe vital signs and urine output, and record. For patients with oliguria and anuria, they should be treated according to acute renal failure. If shock symptoms appear, they should be rescued with anti-shock.