VI. Transfusion Reactions
There are several types of tranfusion reactions (see Table 2). When a
transfusion reaction is suspected, the transfusion should be stopped. The blood
bank should be notified. The transfused blood must be cultured. A new type and
crossmatch of the patient should be performed. CBC, Bilirubin, LDH, and
Coomb’s test should be send
Transfusion reactions can take several forms and occur from exposure to
proteins, red blood cells, white blood cells, platelets or their breakdown products.
A study evaluating 2509 transfusions in 305 pediatric intensive care unit patients
revealed 40 acute transfusion reactions (1.6%). The majority of these reactions
were febrile nonhemolytic reaction] [18}.^ Febrile nonhemolytic reactions occur in
children who have previous exposure from transfusion or pregnancy. This
reaction is due to acquired antibodies to proteinacious material in the blood.
Pretreatment with antipyretic agents, anti-inflammatory agents or antihistamines
may alleviate the symptoms. Hemolytic reactions are rare and when they occur
the infusion should be stopped. Typical symptoms may include fever, pain,
tachycardia, hypotension, renal failure or hemoglobinuria.
Currently screening for HIV and other infectious agents has made these
rare events. Transmission of HIV occurs in 1 in 2.3 million units of blood
transferred [19].^ Hepatitis B and C are transmitted in 1 in 280,000 units and 1 in
1.8 million units transfused respectively. CMV transmission is also minimized by
using leukocyte-reduced RBC’s as CMV is carried in leukocytes [19,20]. Given
the reduction in transmission of infectious agents seen, transfusion related acute
marcin
(Marcin)
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