Matching: Acute Tranfusion Reaction Matchup

Created by

Sara Smith

United States


Acute Tranfusion Reaction MatchupOnline version Group cause, prevention, treatment for each transfusion reaction type. by Sara Smith 1 Acute HTR 2 Anaphylactic Allergic Tranfusion Reaction 3 Uticarial Allergic Tranfusion Reactions 4 Transfusion-Related Acute Lung Injury (TRALI) 5 Bacterial Contamination (Transfusion Associated Sepsis) 6 Transfusion Associated Circulatory Overload (TACO) 7 Nonimmune Hemolysis due to Physical or Chemical Means 8 Hypotension Associated with ACE Inhibition 9 Air Embolus 10 Hypocalcemia (Ionized Calcium/Citrate Toxicity) 11 Hypothermia 12 Febrile Nonhemolytic Transfusion Reactions Cause: incompatibility of red cells causing rapid hemolysis of donor cells by preformed antibodies. Prevention: decrease opportunity for human error Treatment: stop tranfusion, keep IV open, treat shock, maintain airway, increase renal blood flow, monitor for DIC. Cause: severe allergic reaction caused by antibodies to donor plasma proteins (such as anti-IgA) Prevention: use washed cells, for IgA-deficient patients with history of anaphylactic response to IgA, do not give products with IgA containing material Treatment: stop tranfusion, treat for hypotension, laryngeal edema, and bronchiolar constriction, position feet up, administer fluids, epinephrine, antihistamines, corticosteroids, beta-2-antagonists Cause: non-severe allergy to donor plasma proteins Prevention: pretreat patient with antihistamines prior to transfusion Treatment: Slow or stop transfusion while antihistamines are administered. Same unit may be started again once antihistamines take effect. Cause: WBC antibodies in donor product react with the patient's WBCs. Leukoagglutination causes aggregates to become trapped in the lungs, causing pulmonary edema. Prevention: Donors with known leukoagglutinins should have their blood used only as washed RBCs. Some multiparous women have been excluded as plasma/plasma product donors in some parts of the world. Treatment: Stop transfusion if Sx manifest during transfusion, provide respiratory support and administer IV steroids. Cause: bacterial growth in stored unit causes sepsis in the recipient. Prevention: strict adherence to donor collection protocols and storage requirements, do not issue units that have any abnormalities that could indicate contamination Treatment: stop transfusion, administer IV antibiotics, Gram stain to confirm contamination, culture bacteria, and treat complications Cause: transfusion of "whole blood" too rapidly in massive transfusion or to patients with impaired cardiac function, leading to circulatory overload and cardiopulmonary distress Prevention: identify susceptible patients, infuse blood as slowly as possible, using small aliquots if necessary Treatment: stop transfusion, place patient upright, administer oxygen, start diuresis, and perform phlebotomy if necessary Cause: blood hemolyzed due to improper storage, transfusion through a too-small needle, or contact with incompatible IV solutions. Prevention: adhere to established blood bank standards Treatment: document cause, rule out other causes of hemolysis, provide support if DIC occurs Cause: inhibited metabolism of bradykinin with infusion of bradykinin or activated prekallikrein Treatment: withdraw ACE inhibition, avoid albumin volume replacement, avoid bedside leukocyte filtration Cause: air infusion via line Treatment: place patient on left side with legs elevated above chest and head Cause: rapid citrate infusion (d/t citrated blood) causing lowered ionized calcium in circulation Treatment: oral calcium supplement for mild cases or IV calcium with monitoring in severe cases. Cause: rapid infusion of cold blood Treatment: use blood warmer Cause: Abs to WBC HLA antigens or accumulated cytokines in unit Prevention: use leuko-reduced components Treatment: antipyretics

Acute Tranfusion Reaction MatchupOnline version

Group cause, prevention, treatment for each transfusion reaction type.

by Sara Smith

Acute HTR

Anaphylactic Allergic Tranfusion Reaction

Uticarial Allergic Tranfusion Reactions

Transfusion-Related Acute Lung Injury (TRALI)

Bacterial Contamination (Transfusion Associated Sepsis)

Transfusion Associated Circulatory Overload (TACO)

Nonimmune Hemolysis due to Physical or Chemical Means

Hypotension Associated with ACE Inhibition

Air Embolus

Hypocalcemia (Ionized Calcium/Citrate Toxicity)

Hypothermia

Febrile Nonhemolytic Transfusion Reactions

Cause: incompatibility of red cells causing rapid hemolysis of donor cells by preformed antibodies.

Prevention: decrease opportunity for human error

Treatment: stop tranfusion, keep IV open, treat shock, maintain airway, increase renal blood flow, monitor for DIC.

Cause: severe allergic reaction caused by antibodies to donor plasma proteins (such as anti-IgA)

Prevention: use washed cells, for IgA-deficient patients with history of anaphylactic response to IgA, do not give products with IgA containing material

Treatment: stop tranfusion, treat for hypotension, laryngeal edema, and bronchiolar constriction, position feet up, administer fluids, epinephrine, antihistamines, corticosteroids, beta-2-antagonists

Cause: non-severe allergy to donor plasma proteins

Prevention: pretreat patient with antihistamines prior to transfusion

Treatment: Slow or stop transfusion while antihistamines are administered. Same unit may be started again once antihistamines take effect.

Cause: WBC antibodies in donor product react with the patient's WBCs. Leukoagglutination causes aggregates to become trapped in the lungs, causing pulmonary edema.

Prevention: Donors with known leukoagglutinins should have their blood used only as washed RBCs. Some multiparous women have been excluded as plasma/plasma product donors in some parts of the world.

Treatment: Stop transfusion if Sx manifest during transfusion, provide respiratory support and administer IV steroids.

Cause: bacterial growth in stored unit causes sepsis in the recipient.

Prevention: strict adherence to donor collection protocols and storage requirements, do not issue units that have any abnormalities that could indicate contamination

Treatment: stop transfusion, administer IV antibiotics, Gram stain to confirm contamination, culture bacteria, and treat complications

Cause: transfusion of "whole blood" too rapidly in massive transfusion or to patients with impaired cardiac function, leading to circulatory overload and cardiopulmonary distress

Prevention: identify susceptible patients, infuse blood as slowly as possible, using small aliquots if necessary

Treatment: stop transfusion, place patient upright, administer oxygen, start diuresis, and perform phlebotomy if necessary

Cause: blood hemolyzed due to improper storage, transfusion through a too-small needle, or contact with incompatible IV solutions.

Prevention: adhere to established blood bank standards

Treatment: document cause, rule out other causes of hemolysis, provide support if DIC occurs

Cause: inhibited metabolism of bradykinin with infusion of bradykinin or activated prekallikrein

Treatment: withdraw ACE inhibition, avoid albumin volume replacement, avoid bedside leukocyte filtration

Cause: air infusion via line

Treatment: place patient on left side with legs elevated above chest and head

Cause: rapid citrate infusion (d/t citrated blood) causing lowered ionized calcium in circulation

Treatment: oral calcium supplement for mild cases or IV calcium with monitoring in severe cases.

Cause: rapid infusion of cold blood

Treatment: use blood warmer

Cause: Abs to WBC HLA antigens or accumulated cytokines in unit

Prevention: use leuko-reduced components

Treatment: antipyretics

Acute Tranfusion Reaction Matchup

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Acute Tranfusion Reaction Matchup

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Acute Tranfusion Reaction MatchupOnline version

by Sara Smith

Acute HTR

Anaphylactic Allergic Tranfusion Reaction

Uticarial Allergic Tranfusion Reactions

Transfusion-Related Acute Lung Injury (TRALI)

Bacterial Contamination (Transfusion Associated Sepsis)

Transfusion Associated Circulatory Overload (TACO)

Nonimmune Hemolysis due to Physical or Chemical Means

Hypotension Associated with ACE Inhibition

Air Embolus

Hypocalcemia (Ionized Calcium/Citrate Toxicity)

Hypothermia

Febrile Nonhemolytic Transfusion Reactions