Chapter 53 Transfusion Reactions to Blood and Cell Therapy Products
Table 53-1 Types of Acute Transfusion Reactions
| Reaction Type | Presenting Signs and Symptoms |
|---|---|
| Acute intravascular hemolytic | Fever, chills, dyspnea, hypotension, tachycardia, flushing, vomiting, back pain, hemoglobinuria, hemoglobinemia, shock |
| Acute extravascular hemolytic | Fever, indirect hyperbilirubinemia, posttransfusion hematocrit increment lower than expected |
| Febrile reaction | Fever, chills |
| Allergic (mild) | Urticaria, pruritus, rash |
| Anaphylactic | Dyspnea, bronchospasm, hypotension, tachycardia, shock |
| Hypervolemic | Dyspnea, tachycardia, hypertension, headache, jugular venous distention |
| Septic | Fever, chills, hypotension, tachycardia, vomiting, shock |
| Transfusion-related acute lung injury | Dyspnea, decreased oxygen saturation, fever, hypotension |
Workup of an Acute Intravascular Hemolytic Transfusion Reaction
If an acute transfusion reaction occurs:
1. Stop blood component infusion immediately.
2. Maintain intravenous access with a suitable crystalloid or colloid solution.
3. Monitor/maintain blood pressure and heart rate.
4. Maintain an adequate airway.
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