What is a febrile reaction to blood transfusion?
Febrile reactions Cause: Fever and chills during transfusion are thought to be caused by recipient antibodies reacting with white cell antigens or white cell fragments in the blood product or due to cytokines which accumulate in the blood product during storage.
What causes febrile reaction?
Most febrile reactions that occur during transfusion of red blood cells are caused by the interaction of leukocyte antibodies in the recipient’s plasma with donor leukocytes, stimulating the release of pro-inflammatory cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF).
How does febrile transfusion reaction occur?
Nonhemolytic febrile transfusion reactions are usually caused by cytokines from leukocytes in transfused red cell or platelet components, causing fever, chills, or rigors. In the transfusion setting, a fever is defined as a temperature elevation of 1º C or 2º F.
How is a febrile transfusion reaction treated?
In febrile, nonhemolytic reactions, fever usually resolves in 15-30 minutes without specific treatment. If fever causes discomfort, oral acetaminophen (325-500 mg) may be administered. Avoid aspirin because of its prolonged adverse effect on platelet function.
What causes febrile Nonhemolytic transfusion reaction?
Most febrile nonhemolytic transfusion reactions (FNHTR) to platelets are caused by cytokines that accumulate in the product during storage. There have been numerous studies that have demonstrated high concentrations of leukocyte- and platelet-derived cytokines in stored platelet products.
What is the most common transfusion reaction?
Febrile non-hemolytic transfusion reactions are the most common reaction reported after a transfusion. FNHTR is characterized by fever or chills in the absence of hemolysis (breakdown of red blood cells) occurring in the patient during or up to 4 hours after a transfusion.
Why does the body reject blood transfusions?
A more common type of rejection of transfused red cells is a delayed hemolytic reaction. In this case, the patient does not have preexisting antibodies to the transfused red cells. Rather, an immune response occurs days to weeks after the transfusion.
What are the signs of a transfusion reaction?
The most common signs and symptoms include fever, chills, urticaria (hives), and itching. Some symptoms resolve with little or no treatment. However, respiratory distress, high fever, hypotension (low blood pressure), and red urine (hemoglobinuria) can indicate a more serious reaction.
How long does it take for a transfusion reaction to occur?
Reactions can occur between 1 day and 4 weeks after the transfusion. A person can acquire these antibodies through previous pregnancies or transfusions.
What are the signs and symptoms of hemolytic reaction?
Symptoms
- Back pain.
- Bloody urine.
- Chills.
- Fainting or dizziness.
- Fever.
- Flank pain.
- Flushing of the skin.
What should you do if a transfusion reaction occurs?
If a reaction is suspected, stop the transfusion and discontinue any plans for future transfusions. If applicable, alerting the blood bank of the reaction as immediately as possible will prevent incorrect transfusion of blood products into another patient, if products were accidentally exchanged.
Which treatment would prevent a transfusion reaction?
The most common approach to preventing FNHTR and allergic reactions is to give the patient premedication with an antipyretic such as paracetamol and an anti-histamine such as diphenydramine. There is very widespread use of these drugs prior to a transfusion.
How is a delayed transfusion reaction treated?
Symptomatic patients experiencing DHTR can be immediately treated with intravenous immunoglobulin (IVIg), adding erythropoietin (EPO) if the DHTR is also associated with reticulocytopenia. Prophylactic anticoagulation is administered to lower the risk of thrombosis associated with EPO administration.
Which patient is least likely to require red blood cell transfusion?
Which patient is least likely to require red blood cell transfusion therapy? A patient with a hemoglobin level of 8 g/dL.
At what level is hemoglobin dangerously low?
A low hemoglobin count is generally defined as less than 13.5 grams of hemoglobin per deciliter (135 grams per liter) of blood for men and less than 12 grams per deciliter (120 grams per liter) for women. In children, the definition varies with age and sex.
Why must blood be transfused 4 hours?
All blood products taken from the blood bank must be hung within 30 minutes and administered (infused) within 4 hours due to the risk of bacterial proliferation in the blood component at room temperature.
What happens if blood is transfused too fast?
When too much blood is transfused too quickly into a patient, it may cause acute left ventricular failure, which is also called transfusion-associated circulatory overload. This generally occurs in older adults and neonates.
At what temperature should blood be transfused?
Whole blood & red cells should be issued from the blood bank in the blood transport box or insulator carrier that will keep the temperature under 10 degree C, if the room temperature is greater than 25 degree C or if there is a possibility that blood will not be transfused within 30 minutes.