| What is this Condition? Transfusion reaction | | | | unexpected decrease in serum hemoglobin, and |
| accompanies or follows intravenous administration | | | | jaundice. |
| of blood components. Its severity varies from | | | | Allergic hemolytic reactions typically don't cause a |
| mild (fever and chills) to severe (acute kidney | | | | fever and are characterized by hives and |
| failure or complete vascular collapse and death), | | | | angioedema, possibly progressing to cough, |
| depending on the amount of blood transfused, the | | | | respiratory distress, nausea and vomiting, |
| type of reaction, and the person's general health. | | | | diarrhea, abdominal cramps, vascular instability, |
| What Causes it? Hemolytic reactions (red blood | | | | shock, and coma. |
| cell rupture) follow transfusion of mismatched | | | | The hallmark of febrile nonhemolytic reactions is a |
| blood. Transfusion with incompatible blood triggers | | | | mild to severe fever that may begin when the |
| the most serious reaction, marked by | | | | transfusion starts or within 2 hours after its |
| intravascular clumping of red blood cells. The | | | | completion. |
| recipient's antibodies (immunoglobulin G or M) | | | | Bacterial contamination causes high fever, nausea |
| adhere to the donated red blood cells, leading to | | | | and vomiting, diarrhea, abdominal cramps and, |
| widespread clumping and destruction of the | | | | possibly, shock. Symptoms of viral contamination |
| recipient's red blood cells and, possibly, the | | | | may not appear for several weeks after |
| development of disseminated intravascular | | | | transfusion. |
| coagulation and other serious effects. | | | | How is it Diagnosed? Confirming a hemolytic |
| Transfusion with Rh-incompatible blood triggers a | | | | transfusion reaction requires proof of blood |
| less serious reaction within several days to 2 | | | | incompatibility and evidence of hemolysis. When |
| weeks. Rh reactions are most likely in women | | | | such a reaction is suspected, the person's blood is |
| sensitized to red blood cell antigens by prior | | | | retyped and crossmatched with the donor's blood. |
| pregnancy or by unknown factors, such as | | | | When bacterial contamination is suspected, a blood |
| bacterial or viral infection, and in people who have | | | | culture should be done to isolate the causative |
| received more than five transfusions. | | | | organism. |
| Allergic reactions are fairly common but only | | | | How is it Treated? At the first sign of a hemolytic |
| occasionally serious. Febrile nonhemolytic reactions, | | | | reaction, the transfusion is stopped immediately. |
| the most common type of reaction. apparently | | | | Depending on the nature of the person's reaction, |
| develop when antibodies in the recipient's plasma | | | | the health care team may:o monitor vital signs |
| attack antIgens. | | | | every 15 to 30 minutes, watching for signs of |
| Bacterial contamination of donor blood, although | | | | shocko maintain an open intravenous line with |
| fairly uncommon, can occur during donor | | | | normal saline solution, insert an indwelling urinary |
| phlebotomy. Also possible is contamination of | | | | catheter, and monitor intake and outputo cover |
| donor blood with viruses (such as hepatitis), | | | | the person with blankets to ease chillso deliver |
| cytomegalovirus, and the organism causing | | | | supplemental oxygen at low flow rates through a |
| malaria. | | | | nasal cannula or hand-held resuscitation bag (called |
| What are its Symptoms? Immediate effects of | | | | an Ambu bag)o administer drugs such as |
| hemolytic transfusion reaction develop within a | | | | intravenous medications to raise blood pressure |
| few minutes or hours after the start of | | | | and normal saline solution to combat shock, |
| transfusion and may include chills, fever, hives, | | | | Adrenalin to treat shortness of breath and |
| rapid heartbeat, shortness of breath, nausea, | | | | wheezing, Benadryl to combat cellular histamine |
| vomiting, tightness in the chest, chest and back | | | | released from mast cells, corticosteroids to |
| pain, low blood pressure. bronchospasm, | | | | reduce inflammation, and Osmitrol or Lasix to |
| angioedema, and signs and symptoms of | | | | maintain urinary function. Parenteral antihistamines |
| anaphylaxis, shock, pulmonary edema, and | | | | and corticosteroids are given for allergic reactions |
| congestive heart failure. In a person having | | | | (arlaphylaxis, a severe reaction, may require |
| surgery under anesthesia, these symptoms are | | | | Adrenalin). Drugs to reduce fever are |
| masked, but blood oozes from mucous | | | | administered for febrile nonhemolytic reactions |
| membranes or the incision. | | | | and appropriate intravenous antibiotics are given |
| Delayed hemolytic reactions can occur up to | | | | for bacterial contamination. |
| several weeks after transfusion, causing fever, an | | | | |