| What Causes it? | | | | fever and are characterized by hives and |
| Hemolytic reactions (red blood cell rupture) follow | | | | angioedema, possibly progressing to cough, respiratory |
| transfusion of mismatched blood. Transfusion with | | | | distress, nausea and vomiting, diarrhea, abdominal |
| incompatible blood triggers the most serious reaction, | | | | cramps, vascular instability, shock, and coma. |
| marked by intravascular clumping of red blood cells. | | | | The hallmark of febrile nonhemolytic reactions is a mild |
| The recipient's antibodies (immunoglobulin G or M) | | | | to severe fever that may begin when the transfusion |
| adhere to the donated red blood cells, leading to | | | | starts or within 2 hours after its completion. |
| widespread clumping and destruction of the recipient's | | | | Bacterial contamination causes high fever, nausea and |
| red blood cells and, possibly, the development of | | | | vomiting, diarrhea, abdominal cramps and, possibly, |
| disseminated intravascular coagulation and other | | | | shock. Symptoms of viral contamination may not |
| serious effects. | | | | appear for several weeks after transfusion. |
| Transfusion with Rh-incompatible blood triggers a less | | | | How is it Diagnosed? |
| serious reaction within several days to 2 weeks. Rh | | | | Confirming a hemolytic transfusion reaction requires |
| reactions are most likely in women sensitized to red | | | | proof of blood incompatibility and evidence of |
| blood cell antigens by prior pregnancy or by unknown | | | | hemolysis. When such a reaction is suspected, the |
| factors, such as bacterial or viral infection, and in | | | | person's blood is retyped and crossmatched with the |
| people who have received more than five | | | | donor's blood. |
| transfusions. | | | | When bacterial contamination is suspected, a blood |
| Allergic reactions are fairly common but only | | | | culture should be done to isolate the causative |
| occasionally serious. Febrile nonhemolytic reactions, the | | | | organism. |
| most common type of reaction. apparently develop | | | | How is it Treated? |
| when antibodies in the recipient's plasma attack | | | | At the first sign of a hemolytic reaction, the transfusion |
| antIgens. | | | | is stopped immediately. Depending on the nature of the |
| Bacterial contamination of donor blood, although fairly | | | | person's reaction, the health care team may:monitor |
| uncommon, can occur during donor phlebotomy. Also | | | | vital signs every 15 to 30 minutes, watching for signs |
| possible is contamination of donor blood with viruses | | | | of shockmaintain an open intravenous line with normal |
| (such as hepatitis), cytomegalovirus, and the organism | | | | saline solution, insert an indwelling urinary catheter, and |
| causing malaria. | | | | monitor intake and outputcover the person with |
| What are its Symptoms? | | | | blankets to ease chillsdeliver supplemental oxygen at |
| Immediate effects of hemolytic transfusion reaction | | | | low flow rates through a nasal cannula or hand-held |
| develop within a few minutes or hours after the start | | | | resuscitation bag (called an Ambu bag)administer drugs |
| of transfusion and may include chills, fever, hives, rapid | | | | such as intravenous medications to raise blood |
| heartbeat, shortness of breath, nausea, vomiting, | | | | pressure and normal saline solution to combat shock, |
| tightness in the chest, chest and back pain, low blood | | | | Adrenalin to treat shortness of breath and wheezing, |
| pressure. bronchospasm, angioedema, and signs and | | | | Benadryl to combat cellular histamine released from |
| symptoms of anaphylaxis, shock, pulmonary edema, | | | | mast cells, corticosteroids to reduce inflammation, and |
| and congestive heart failure. In a person having | | | | Osmitrol or Lasix to maintain urinary function. |
| surgery under anesthesia, these symptoms are | | | | Parenteral antihistamines and corticosteroids are given |
| masked, but blood oozes from mucous membranes or | | | | for allergic reactions (arlaphylaxis, a severe reaction, |
| the incision. | | | | may require Adrenalin). Drugs to reduce fever are |
| Delayed hemolytic reactions can occur up to several | | | | administered for febrile nonhemolytic reactions and |
| weeks after transfusion, causing fever, an unexpected | | | | appropriate intravenous antibiotics are given for |
| decrease in serum hemoglobin, and jaundice. | | | | bacterial contamination. |
| Allergic hemolytic reactions typically don't cause a | | | | |