transfusion reaction

[dochubert]

Has anyone ever heard of a patient getting a reaction from transfusing blood too quickly ie fever, tachycardia?

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[Jaded Soul]

I don't remember if the rate of administration has anything to do with it, but non-hemolytic transfusion reactions aren't uncommon. The patient can spike a fever, experience chills and rigors, and become dyspnic within hours of getting blood products. Some of the residents I've worked with will premedicate with Tylenol and Demerol, though I remember reading that it's not always a good idea because you can mask a more serious hemolytic transfusion reaction.

If the patient has had reactions in the past, giving them leukocyte-depleted blood products can decrease the chance of having a subsequent reaction. Has something to do with fewer donor WBCs producing fewer cytokines.

 

[Idiopathic]

Isnt this a mild variant of graft-vs-host immune response? Sort of a blood 'rejection'?

 

[undecided05]

no it's not like a GVH reaction b/c that would require antibodies and antigens, but a blood transfusion causing fever is based off of interleukens being released in the blood. (I think IL-1 and maybe IL-6, but don't quote me on that part)
Also by premedicating with Tylenol you prevent that fever, but it's not a rejection. A rejection is characterized with symptoms of pain at the transfusion sight, hypotension, and fever to an extent b/c of hemolysis, but fever alone is no reason to stop a blood transfusion as long as it's not a fever that's going to fry the brain.