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What is this condition? Transfusion reaction accompanies or follows intravenous administration of blood components. Its severity varies a mild fever (and chills) to severe (acute renal failure or complete vascular collapse and death), depending on the amount of blood transfused, the type of reaction, and general health of the person.
What causes it? Hemolytic reactions (breakdown of red blood cells) are the mismatched blood transfusion. The transfusion of incompatible blood triggers the most serious reaction, marked by intravascular clumping of red blood cells. Receptor antibodies (immunoglobulin G or M) adhere to red blood cells from donated blood, leading to group and destruction of red blood cell receptor and possibly the development of disseminated intravascular coagulation and other serious effects.
Rh incompatible blood transfusion triggers a less severe reaction in several days to 2 weeks. Rh reactions are more likely in women sensitized to red cell antigens by prior pregnancy or by unknown factors, such as infection bacterial or viral infection, and people who have received more than five transfusions.
Allergic reactions are very common but only occasionally serious. The nonhemolytic febrile reactions, the most common type of reaction. development apparently when antibodies attack the antigens in the recipient plasma.
Bacterial contamination of donor blood, although rare, may occur during donor phlebotomy. It is also possible contamination of donor blood with viruses (like hepatitis), cytomegalovirus and malaria-causing organism.
What are the symptoms? Immediate effects hemolytic transfusion reaction develop within minutes to hours after the start of the transfusion and may include chills, fever, urticaria, palpitations, shortness of breath, nausea, vomiting, chest tightness, chest and back pain, low blood pressure. bronchospasm, angioedema, and signs and symptoms of anaphylaxis, shock, pulmonary edema and congestive heart failure. In a person having surgery under general anesthesia, these symptoms are masked, but blood oozes from mucous membranes or the incision.
Delayed hemolytic reactions can occur until several weeks after transfusion, causes fever, an unexpected decrease in serum hemoglobin, and jaundice.
Allergic reactions usually cause hemolytic characterized by fever and urticaria and angioedema, possibly progressing to cough, difficulty breathing, nausea and vomiting, diarrhea, abdominal cramps, vascular instability, shock and coma.
The hallmark of febrile nonhemolytic reactions is a mild to severe fever that may begin when the transfusion starts or within 2 hours after completion.
Bacterial contamination causes high fever, nausea and vomiting, diarrhea, abdominal cramps and, possibly, shock. The symptoms of contamination virus can not appear several weeks after transfusion.
How is it diagnosed? Confirming a hemolytic transfusion reaction requires proof of blood incompatibility and evidence of hemolysis. When this reaction is suspected, the blood of the person is typing and crossmatch with donor blood.
When bacterial contamination is suspected, a blood culture should be done to isolate the causative organism.
How is it treated? In the first sign of a hemolytic reaction, the transfusion is stopped immediately. Depending on the nature of the reaction of the person, the health team can:
or monitor vital signs every 15 to 30 minutes, watching for signs of shock
open or maintain an intravenous line with saline normal, insert an indwelling urinary catheter, and monitor the inputs and outputs
or cover the person with blankets to alleviate chills
or provide supplemental oxygen at low flow rates through a nasal cannula or hand-held resuscitation bag (Ambu call)
or administer medicines, such as intravenous medications to increase blood pressure and normal saline to combat shock, epinephrine to treat breathlessness and wheezing, Cellular Benadryl to combat the histamine released from mast cells, corticosteroids to reduce inflammation and Lasix to keep Osmitrol or urinary function. Antihistamines and parenteral corticosteroids given for allergic reactions (arlaphylaxis, severe reactions may require adrenaline). Medicines to reduce fever are administered by the nonhemolytic febrile reactions and appropriate intravenous antibiotics are given for bacterial contamination.
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