What is the common presentation of Non-haemolytic febrile reaction?

fever

What is the management of Non-haemolytic febrile reaction?

• Slow or stop the transfusion
• Paracetamol
• Monitor

What is the pathophysiology of Non-haemolytic febrile reaction?

caused by antibodies reacting with white cell fragments in the blood product and cytokines that have leaked from the blood cell during storage

What are the main clinical features of Minor allergic reaction (Blood product transfusion complications)?

• Pruritus
• urticaria

What is the management of Minor allergic reaction (Blood product transfusion complications)?

• Temporarily stop the transfusion
• Antihistamine
• Monitor

What is the pathophysiology of Minor allergic reaction (Blood product transfusion complications)?

Thought to be caused by foreign plasma proteins

What are the main clinical features of Anaphylaxis (Blood product transfusion complications)?

• Hypotension
• dyspnoea
• wheezing
• angioedema.

What is the management of Anaphylaxis (Blood product transfusion complications)?

• Stop the transfusion
• IM adrenaline
• Resuscitation

What is the pathophysiology of Anaphylaxis (Blood product transfusion complications)?

Can be caused by patients with IgA deficiency who have anti-IgA antibodies

What is the common presentation of Acute haemolytic reaction (Blood product transfusion complications)?

• Fever
• abdominal pain
• hypotension

How is Acute haemolytic reaction (Blood product transfusion complications) diagnosed?

send blood for direct Coombs test, repeat typing and cross-matching

What are the main causes of Acute haemolytic reaction (Blood product transfusion complications)?

ABO-incompatible blood e.g. secondary to human error

What is the pathophysiology of Acute haemolytic reaction?

a mismatch of blood group (ABO) which causes massive intravascular haemolysis. This is usually the result of red blood cell destruction by IgM-type antibodies.

How long after starting the transfusion does Acute haemolytic reaction present?

within minutes

What are the possible complications of Acute haemolytic reaction?

• disseminated intravascular coagulation
• renal failure

What is the common presentation of Transfusion-associated circulatory overload?

• Pulmonary oedema
• hypertension

What is the management of Transfusion-associated circulatory overload?

• Slow or stop transfusion
• Consider intravenous loop diuretic

What are the main causes of Transfusion-associated circulatory overload?

Excessive rate of transfusion, pre-existing heart failure

What are the main clinical features of Transfusion-related acute lung injury?

• Hypoxia
• pulmonary infiltrates on chest x-ray
• fever
• hypotension

What is the management of Transfusion-related acute lung injury?

• Stop the transfusion
• Oxygen and supportive care

What is the pathophysiology of Transfusion-related acute lung injury?

Non-cardiogenic pulmonary oedema thought to be secondary to increased vascular permeability caused by host neutrophils that become activated by substances in donated blood

How long after starting a blood transfusion is Transfusion-related acute lung injury typically seen?

ARDS symptoms develop within 6 hours