Blood Transfusion Complications
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Questions and Answers

What is the progressive risk associated with increasing transfusion volume?

  • Transfusion-specific complications (correct)
  • Hypothermia
  • Clotting abnormalities
  • Electrolyte abnormalities

    • Why do clotting abnormalities occur during packed red cell transfusions?

  • Due to the presence of calcium binding agents
  • Due to a dilution effect as packed red cells do not contain platelets or clotting factors (correct)
  • Due to the presence of platelets and clotting factors
  • Due to the release of intracellular potassium

    • What is the purpose of administering fresh frozen plasma and platelets concurrently?

  • To reduce the risk of transfusion-specific complications
  • To reduce the risk of hypothermia
  • To reduce the risk of clotting impairment (correct)
  • To reduce the risk of electrolyte abnormalities

    • What is the cause of hypocalcaemia during blood transfusions?

    <p>Chelation of calcium by the calcium binding agent</p> Signup and view all the answers

    What is the cause of hyperkalaemia during blood transfusions?

    <p>Release of intracellular potassium due to haemolysis</p> Signup and view all the answers

    Why is regular monitoring of core body temperature required during blood product transfusion?

    <p>To monitor for hypothermia</p> Signup and view all the answers

    What is the consequence of rapid transfusion of blood products?

    <p>Drop in patient’s core temperature</p> Signup and view all the answers

    How are transfusion-specific complications categorized?

    <p>Acute and delayed complications</p> Signup and view all the answers

    What is the most common cause of an acute haemolytic reaction?

    <p>Blood group incompatibility</p> Signup and view all the answers

    What is the typical presentation of a patient with an acute haemolytic reaction?

    <p>Urticaria, hypotension, and fever</p> Signup and view all the answers

    What is the purpose of performing a Direct Antiglobulin Test (DAT) in a patient with suspected acute haemolytic reaction?

    <p>To confirm the diagnosis of acute haemolytic reaction</p> Signup and view all the answers

    What is the immediate action to take if you suspect an acute haemolytic reaction?

    <p>Stop the transfusion and begin supportive measures</p> Signup and view all the answers

    What is the treatment for Transfusion Associated Circulatory Overload (TACO)?

    <p>Oxygen therapy and diuretic therapy</p> Signup and view all the answers

    What is the purpose of prescribing furosemide prophylactically during a transfusion?

    <p>To prevent Transfusion Associated Circulatory Overload (TACO)</p> Signup and view all the answers

    What is the typical presentation of a patient with Transfusion Related Acute Lung Injury (TRALI)?

    <p>Dyspnoea and features of pulmonary oedema</p> Signup and view all the answers

    What is the treatment for Transfusion Related Acute Lung Injury (TRALI)?

    <p>High-flow oxygen and urgent chest radiograph</p> Signup and view all the answers

    Study Notes

    Complications of Packed Red Cell Transfusions

    • Clotting abnormalities can occur due to dilution effect, especially in trauma patients
    • To reduce the risk of clotting impairment, fresh frozen plasma and platelets should be administered concurrently, typically for patients receiving more than 4 units of RBCs

    Electrolyte Abnormalities

    • Hypocalcaemia: chelation of calcium by the calcium binding agent in the preservative results in reduced serum calcium level
    • Hyperkalaemia: due to partial haemolysis of the red blood cells and the resultant release of intracellular potassium

    Hypothermia

    • Rapid transfusion of blood products kept at cool temperatures can lead to a drop in the patient's core temperature
    • Regular monitoring of core body temperature is required during blood product transfusion

    Transfusion-Specific Complications

    Acute Transfusion Complications

    • Acute Haemolytic Reaction: a serious reaction caused by transfusion of the incorrect blood type, the most common cause being ABO blood group incompatibility
    • Symptoms include urticaria, hypotension, fever, haemoglobinuria, and evidence of haemolysis
    • Diagnosis confirmed by reduced Hb, low serum haptoglobin, high LDH and bilirubin, and a positive Direct Antiglobulin Test (DAT)
    • Treatment involves urgently informing the blood bank, stopping the transfusion, and providing supportive measures like fluid resuscitation and oxygen supplementation
    • Transfusion Associated Circulatory Overload (TACO): presents with dyspnoea and features of fluid overload
    • Treatment involves oxygen and diuretic therapy, with 20mg furosemide prophylactically prescribed during the transfusion to prevent overload
    • Transfusion Related Acute Lung Injury (TRALI): a form of Acute Respiratory Distress Syndrome (ARDS), a non-cardiogenic cause of pulmonary oedema
    • Treatment involves high flow oxygen and urgent chest radiograph, with specialist and intensive care input urgently required

    Other Complications

    • Mild Allergic Reaction: patient complains of pruritus (itching), treated with an anti-histamine

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    Description

    This quiz covers complications of packed red cell transfusions, including clotting abnormalities and their likelihood of occurrence with increasing transfusion volume.

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