recognition of acute transfusion reactions

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recognition of acute transfusion reactions

Category 1: mild reactions

  • signs
    • localized cutaneous reactions (urticaria, rash)
  • symptoms
    • pruritus
  • possible cause
    • hypersensitivity (mild)

Category 2: moderately severe reaction

  • signs
    • flushing
    • urticaria
    • rigors
    • fever
    • restlessness
    • tachycardia
  • symptoms
    • anxiety
    • pruritus
    • palpitations
    • mild dyspnoea
    • headache
  • possible cause
    • hypersensitivity (moderate-severe)
    • febrile non haemolytic transfusion reactions
      • antibodies to white blood cells,platelets
      • antibodies to proteins including IgA
    • possible contamination with pyogens and/or bacteria

Category 3: life threatening reactions

  • signs
    • rigors
    • fever
    • restlessness
    • hypotension (fall of ≥20% in systolic BP)
    • tachycardia (rise of ≥20% in heart rate)
    • haemoglobinuria (red urine)
    • unexplained bleeding (DIC)
  • symptoms
    • anxiety
    • chest pain
    • pain near infusion site
    • respiratory distress/shortness of breath
    • loin/back pain
    • headache
    • dyspnoea
  • possible cause
    • acute intravascular haemolysis
    • bacterial contamination and septic shock
    • fluid overload
    • anaphylaxis
    • transfusion-associated acute lung injury (TRALI)

Reference:

Last reviewed 01/2018