Complications of Packed Red Cell Transfusions
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Questions and Answers

What is the primary cause of acute haemolytic reaction?

  • ABO blood group incompatibility (correct)
  • Blood bank error
  • Transfusion of incorrect blood type
  • Donor red blood cells destroyed by recipient's antibodies

    • What are the symptoms of acute haemolytic reaction?

  • Dyspnoea, hypotension, and fever
  • Urticaria, fever, and haemoglobinuria
  • Fever, haemoglobinuria, and fluid overload
  • Urticaria, hypotension, and haemoglobinuria (correct)

    • What is the treatment for acute haemolytic reaction?

  • Anti-histamine treatment and blood transfusion
  • Oxygen therapy and diuretic therapy
  • Urgent blood bank notification and supportive measures (correct)
  • Fluid resuscitation and blood transfusion

    • What is the purpose of prescribing 20mg furosemide during transfusion?

    <p>To prevent transfusion-associated circulatory overload</p> Signup and view all the answers

    What is the characteristic of transfusion-related acute lung injury (TRALI)?

    <p>Non-cardiogenic cause of pulmonary oedema</p> Signup and view all the answers

    What is the treatment for transfusion-related acute lung injury?

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

    What is the characteristic of mild allergic reaction?

    <p>Pruritus and urticaria</p> Signup and view all the answers

    What is the consequence of untreated transfusion-related acute lung injury?

    <p>High mortality rate</p> Signup and view all the answers

    What is the cause of clotting abnormalities in packed red cell transfusions?

    <p>Dilution effect due to lack of platelets and clotting factors in transfused cells</p> Signup and view all the answers

    What is the recommended course of action to reduce the risk of clotting impairment in patients receiving more than 4 units RBCs?

    <p>Administering fresh frozen plasma and platelets concurrently</p> Signup and view all the answers

    What is the cause of hypocalcaemia in blood transfusions?

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

    What is the result of the partial haemolysis of red blood cells during blood transfusions?

    <p>Hyperkalaemia</p> Signup and view all the answers

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

    <p>To prevent hypothermia due to rapid transfusion of cool blood products</p> Signup and view all the answers

    What is the main reason for hypothermia in blood transfusions?

    <p>Rapid transfusion of blood products</p> Signup and view all the answers

    What is the classification of transfusion-specific complications that occur soon after the transfusion has been started?

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

    What is the main factor that increases the risk of complications in packed red cell transfusions?

    <p>Increasing transfusion volume</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 the complications that arise from packed red cell transfusions, including clotting abnormalities and their causes.

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