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8/4/2019 Complications and Risks of Blood Transfusions
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4/15/12
Tarek ABDULLAH alnizamiId:08090149
Complications and Risks of Blood
Transfusions
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Blood transfusion is the process of transferring blood or blood-basedproducts from one person into the circulatory system of another. Bloodtransfusions can be life-saving in some situations, such as massive
blood loss due to trauma, or can be used to replace blood lost duringsurgery.
Blood transfusions may also be used to treat a severe anemia orthrombocytopenia caused by a blood disease. People suffering fromhemophilia or sickle-cell disease may require frequent bloodtransfusions. Early transfusions used whole blood, but modern medicalpractice commonly uses only components of the blood.
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Most transfusions are not associated with any form of reactions.However, reactions can occur with any blood component. The reactionmay occur at the time of the transfusion, such as (febrile reaction) or
the destruction of the transfused red cells (hemolytic reaction).
Other effects, such as the transmission of viruses, are not apparent untilweeks or months later, after the incubation period and the onset of thedisease.
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The symptoms of most of the reactions include:
the development of a fever, chills, nausea
pain at the site of the transfusion (arm vein) .
shortness of breath.
a drop in blood pressure.
passing dark or red urine.
skin rash.
Serious complications can be prevented by early recognition of a reaction,
stopping the transfusion and limiting the amount of blood given.
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Risks of Transfusion
a. Transfusion Reactions
a. Transmission of Infections
a. Immunomodulation
a. Transfusion-associated acute lung injury
a. Graft Versus Host Disease
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Transfusion Reaction NonHemolytic
Febrile Reaction (The most common)
caused by cytokines from leukocytes in transfused red cell or plateletcomponents
Chills, Fever
Headache, Sweatiness
15min-1hr
Anaphylactic Reaction orAllergic reactions (in people with IgAdeficiency)
Urticaria
Abdominal cramps
Dyspnea, Vomiting, Diarrhea
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Treatment
Stop Transfusion
Give AntiHistamines
Administer epinephrine/ corticosteroid
Support airway and circulation as necessary
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Transfusion Reaction Hemolytic
most commonly due to the administration of mismatched blood types.
Acute Reaction
Burning at the intravenous (IV) line site
Fever, Chills, Dyspnea
Cardiovascular Collapse & Shock
Hemoglobinuria, Hemoglobinemia
Renal Failure
DIC (Disseminated intravascular coagulation)
Delayed Reaction
Fever
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Treatment
Stop Transfusion immediately
Check the name, type and crossmatch
Urine Exam
Renal Protection
DIC Monitor
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Transmission of Infections
Viruses
HIV, HBV, HCV, Cytomegalovirus (CMV)
Bacteria
E.coli, Yersinia
Parasites
Malaria
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Immunomodulation
The transfusions can cause decreases in immune function. The medical
term for this effect is immunomodulation. It is not clear what theimplications of this effect.
Immunosuppressive effect of Transfusion
Mediated by WBCs
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Transfusion-associated acute lung injury
TRALI is a syndrome of acute respiratory distress, often associated withfever, non-cardiogenic pulmonary edema, and hypotension, which mayoccur as often as 1 in 2000 transfusions.
Symptoms can range from mild to life-threatening, but most patientsrecover fully within 96 hours, and the mortality rate from this conditionis less than 10%.
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Graft Versus Host Disease
Donor white cells (lymphocytes) can attack the recipients skin, liver,bowel and marrow after blood or marrow stem cell transplantation.
Although this is very uncommon, it may happen in patients whohave decreased immune system function, referred to asimmunosuppressed or immunocompromised.
The symptoms include low blood pressure and fever. It is also lifethreatening.
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Massive Transfusion
Replacement of patients blood volume OR 10 units infew hours
RISKS
Volume overload
Acid Base disturbance
Hypocalcemia
Coagulopathy ----
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Thank you
for your attention