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Blood Transfusion Complications

Posted by: Frances Quino, RN

December 1, 2011 Comments (2)

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Blood transfusions always come with variousside effects and complications. The health team, especially the doctors and nurses should be

responsible in educating the patients receiving blood transfusion regarding the reason of thetransfusion, its benefits and risks involve and the expected outcomes during transfusions. It is

also important that we obtain a signed consent from the patients agreeing to undergo atransfusion. Nursing management is focused on recognizing, preventing and intervening

complications.

Acute Hemolytic Reaction - This is the most dangerous and most fatal transfusion reactionthere is. Thus happens when the blood donor is incompatible to the blood recipient. Antibodies

present in the blood recipient plasma combine with the antigens of the donor plasma causing thedestruction of red blood cells in the circulation. This type of reaction can occur very quickly just

after transfusing 10 mL of blood. Symptoms include fever, chills, low back pain, nausea, chesttightness, dyspnea and anxiety. When RBCs are destroyed, the hemoglobin is released in the

urine. This leads to hypotension, bronchospasm and vascular collapse that may be eventuallycause acute renal failure. The transfusion should be stopped eventually and reassessment of the

patient should be initiated (blood volume and renal perfusion). Laboratories (blood and urine

specimen) should be evaluated.

Delayed Hemolytic Reaction - After transfusion, reactions may be delayed; antibodies react a

little later and have increased in time. This occurs within 14 days after transfusion. Signs andsymptoms include fever, increased bilirubin levels, decreased or absent haptoglobin, anemia, and

jaundice,

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Febrile Non Hemolytic Reaction - This is the most common type of transfusion reaction. Thisreaction is caused by anti bodies to donor WBCs that are still present in the blood unit or

blood component. Patients with febrile non haemolytic reaction manifests fever (starts twohours after the transfusion), chills and muscle stiffness. In order to prevent such, before

transfusion, he blood can undergo a leukocyte reduction filter to eliminate WBCs in the blood

component. Antipyretics are given as ordered, tepid sponge bath is rendered and continuousmonitoring is done.

Allergic Reaction - This reaction is due to a sensitivity reaction to a plasma protein from theblood being transfused. Symptoms include flushing, itching and urticaria, severe allergic reaction

includes bronchospasms, laryngeal edema and shock. Management includes administration ofantihistamines, epinephrine and corticosteroids as ordered.

Circulatory Overload - If too much blood is transfused then this may cause circulatory overload

or hpervolemia. Signs and symptoms would be orthopnea, dyspnea, tachycardia and anxiety,crackles, neck vein distention and hypertension. Slowing the rate of transfusion and

administering diuretics as ordered is the intervention for such. Oxygen inhalation can also beinitiated.

Bacterial Contamination - Contaminated blood products are very dangerous since it maytransmit a disease or infection to the recipient. Signs and symptoms of bacterial contamination

are fever, chills and hypotension. Antibiotics are administered as ordered to treat the infection asearly as possible.

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SOURCE : NURSINGCRIB.COM