This document provides information about blood transfusion and transfusion reactions. It discusses the types of whole blood and blood components that can be transfused, including red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It describes the indications for different blood component transfusions. The document also outlines the important tests that must be performed prior to transfusion, including blood typing and antibody screening. Finally, it examines the various types of transfusion reactions that can occur, including acute hemolytic, febrile, allergic, and delayed hemolytic reactions, as well as TRALI and TACO. It provides the signs, symptoms, and management of each type of reaction.
Blood transfusions have evolved significantly since the first animal-to-human transfusion in 1665. Key developments include the discovery of blood groups by Landsteiner in 1901, which helped reduce transfusion reactions. Major risks of transfusion include febrile reactions, allergic reactions, respiratory complications like TRALI, and rare but serious events like hemolytic reactions and disease transmission. Proper screening and typing has made transfusions much safer, but complications remain a risk, especially with massive transfusions required for trauma patients. Researchers continue working on blood substitutes to reduce donor dependence and risks of allogeneic transfusion.
4. Blood and blood product transfusion and complications.pptxRebiraWorkineh
Blood transfusion is an integral part of medical treatment but carries risks of complications. Acute transfusion reactions include hemolytic reactions which can be fatal if incompatible blood is transfused, febrile reactions caused by antibodies to HLA antigens, and allergic reactions treated with antihistamines. Chronic risks include alloimmunization against minor antigens, transfusion-associated graft-versus-host disease which is usually fatal, and transmission of infections like hepatitis and HIV without proper screening. Hospitals have protocols to properly screen and match blood and monitor for complications during and after transfusions.
This document provides an overview of blood transfusion, including:
- Classifying hemorrhage as revealed or concealed, primary/reactionary/secondary, and surgical vs non-surgical.
- Describing components of whole blood that can be transfused including packed red blood cells, platelet concentrate, fresh frozen plasma, and cryoprecipitate.
- Explaining the purpose of transfusions is to increase circulating volume and hemoglobin levels or provide clotting factors.
- Detailing complications like hemolytic reactions, febrile reactions, transfusion-related lung injury, and circulatory overload that can occur without proper testing and transfusions.
Transfusion medicine involves preparing and administering various blood components for different indications. Red blood cells, platelets, plasma, and cryoprecipitate each have specific storage, dosing, and compatibility considerations. Potential acute transfusion reactions include hemolytic, febrile non-hemolytic, allergic, and transfusion-related acute lung injury reactions. Chronic issues may involve alloimmunization, iron overload, or transfusion-transmitted infections. Proper screening, component preparation, and administration techniques can help prevent or minimize complications.
Transfusion medicine involves preparing and administering various blood components for different indications. Red blood cells, platelets, plasma, and cryoprecipitate each have specific storage, dosing, and compatibility considerations. Potential acute transfusion reactions include hemolytic, febrile non-hemolytic, allergic, and transfusion-related acute lung injury reactions. Chronic issues are alloimmunization, iron overload, and transfusion-transmitted infections. Proper component preparation and administration along with prevention methods can reduce complications of transfusions.
This document provides information about blood transfusion for anesthesia. It discusses the components of blood, types of transfusions including whole blood, packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It outlines general indications for transfusion including anemia management and volume replacement. It also discusses complications of transfusion such as febrile reactions, allergic reactions, hemolytic reactions, transfusion-related acute lung injury, and transfusion-associated circulatory overload. Monitoring during transfusion and preventing complications are also covered.
This document provides information about blood transfusion for anesthesia. It discusses the components of blood, types of transfusions including whole blood, packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It outlines general indications for transfusion including anemia management and volume replacement. It also discusses complications of transfusion such as febrile reactions, allergic reactions, hemolytic reactions, transfusion-related acute lung injury, and transfusion-associated circulatory overload. Monitoring during transfusion and preventing complications are also covered.
Blood transfusions have evolved significantly since the first animal-to-human transfusion in 1665. Key developments include the discovery of blood groups by Landsteiner in 1901, which helped reduce transfusion reactions. Major risks of transfusion include febrile reactions, allergic reactions, respiratory complications like TRALI, and rare but serious events like hemolytic reactions and disease transmission. Proper screening and typing has made transfusions much safer, but complications remain a risk, especially with massive transfusions required for trauma patients. Researchers continue working on blood substitutes to reduce donor dependence and risks of allogeneic transfusion.
4. Blood and blood product transfusion and complications.pptxRebiraWorkineh
Blood transfusion is an integral part of medical treatment but carries risks of complications. Acute transfusion reactions include hemolytic reactions which can be fatal if incompatible blood is transfused, febrile reactions caused by antibodies to HLA antigens, and allergic reactions treated with antihistamines. Chronic risks include alloimmunization against minor antigens, transfusion-associated graft-versus-host disease which is usually fatal, and transmission of infections like hepatitis and HIV without proper screening. Hospitals have protocols to properly screen and match blood and monitor for complications during and after transfusions.
This document provides an overview of blood transfusion, including:
- Classifying hemorrhage as revealed or concealed, primary/reactionary/secondary, and surgical vs non-surgical.
- Describing components of whole blood that can be transfused including packed red blood cells, platelet concentrate, fresh frozen plasma, and cryoprecipitate.
- Explaining the purpose of transfusions is to increase circulating volume and hemoglobin levels or provide clotting factors.
- Detailing complications like hemolytic reactions, febrile reactions, transfusion-related lung injury, and circulatory overload that can occur without proper testing and transfusions.
Transfusion medicine involves preparing and administering various blood components for different indications. Red blood cells, platelets, plasma, and cryoprecipitate each have specific storage, dosing, and compatibility considerations. Potential acute transfusion reactions include hemolytic, febrile non-hemolytic, allergic, and transfusion-related acute lung injury reactions. Chronic issues may involve alloimmunization, iron overload, or transfusion-transmitted infections. Proper screening, component preparation, and administration techniques can help prevent or minimize complications.
Transfusion medicine involves preparing and administering various blood components for different indications. Red blood cells, platelets, plasma, and cryoprecipitate each have specific storage, dosing, and compatibility considerations. Potential acute transfusion reactions include hemolytic, febrile non-hemolytic, allergic, and transfusion-related acute lung injury reactions. Chronic issues are alloimmunization, iron overload, and transfusion-transmitted infections. Proper component preparation and administration along with prevention methods can reduce complications of transfusions.
This document provides information about blood transfusion for anesthesia. It discusses the components of blood, types of transfusions including whole blood, packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It outlines general indications for transfusion including anemia management and volume replacement. It also discusses complications of transfusion such as febrile reactions, allergic reactions, hemolytic reactions, transfusion-related acute lung injury, and transfusion-associated circulatory overload. Monitoring during transfusion and preventing complications are also covered.
This document provides information about blood transfusion for anesthesia. It discusses the components of blood, types of transfusions including whole blood, packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It outlines general indications for transfusion including anemia management and volume replacement. It also discusses complications of transfusion such as febrile reactions, allergic reactions, hemolytic reactions, transfusion-related acute lung injury, and transfusion-associated circulatory overload. Monitoring during transfusion and preventing complications are also covered.
Blood transfusion and its complication.pptxNishiThawait
Blood transfusion involves transferring blood or blood components from a donor to a recipient. It is a life-saving procedure but can also lead to adverse reactions. Precautions must be taken before transfusion to ensure compatible blood types, including blood grouping, crossmatching, and screening donors for diseases. Potential transfusion complications include acute hemolytic reactions, febrile reactions, allergic reactions, circulatory overload, and infections being transmitted from the donor. Long term issues may also occur like iron overload, graft-versus-host disease, or post-transfusion purpura. Careful patient monitoring during and after transfusion can help manage any reactions.
This document discusses complications that can occur from blood transfusions. It describes various types of immunologic reactions like acute and delayed hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, and post-transfusion purpura. It also discusses infectious complications from transfusions like viruses, bacteria, and other pathogens. Massive blood transfusions are outlined as carrying additional risks such as acidosis, hyperkalemia, citrate toxicity, hypocalcemia, metabolic alkalosis, iron overload, fluid overload, and hypothermia. Prevention strategies and treatment approaches for various complications are provided.
Blood and blood products were presented. Key points included:
1. Blood functions to transport vital substances throughout the body.
2. Blood typing and cross-matching must be done correctly to avoid transfusion reactions.
3. Several blood products exist including packed red blood cells, platelets, and plasma derivatives that are used to treat different conditions.
4. Blood transfusions can have complications and must only be done when necessary following all safety protocols.
This document summarizes information about blood transfusions. It discusses the history and development of blood transfusions, indications for transfusions, blood grouping and compatibility testing, potential complications, available blood components, and safe transfusion procedures. The presenter provides an overview of topics related to blood transfusions including donor screening, storage and handling of blood products, monitoring for side effects, and documentation of the transfusion process.
Blood and blood products can be used to treat various medical conditions. Whole blood contains red blood cells, white blood cells, platelets, and plasma. It is used to treat acute blood loss. Other blood products include packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. These treat specific deficiencies or conditions. Potential complications of transfusion include acute lung injury, circulatory overload, hemolytic reactions, allergic reactions, anaphylaxis, sepsis, and delayed reactions. Careful patient monitoring during and after transfusion can help reduce risks.
ADVERSE EFFECTS OF BLOOD TRANSFUSION.pptxdipyapatho
Adverse transfusion reactions:Adverse transfusion reactions are unwanted or harmful responses that can occur as a result of receiving a blood transfusion. While blood transfusions are generally safe, adverse reactions can happen in some cases. Here are some common types of adverse transfusion reactions in the presentation
This document discusses various types of transfusion reactions, their causes, signs and symptoms, investigations, management, and prevention. It describes hemolytic transfusion reactions caused by ABO incompatibility or other antibodies which can be acute and life-threatening or delayed. Non-hemolytic reactions include febrile non-hemolytic reactions, allergic reactions, anaphylaxis, circulatory overload, and graft-versus-host disease. Investigations of transfusion reactions include blood samples, urine analysis, and cultures to identify the cause and guide appropriate treatment.
Transfusion reactions can occur during or after blood transfusion and range from mild to life-threatening. The major causes are misidentification of patient, blood or sample, or administration errors. Reactions can be infectious, from pathogens in blood, or non-infectious, which include immune reactions (e.g. hemolytic), non-immune reactions (e.g. transfusion-associated circulatory overload), or errors in storage or administration (e.g. hypothermia, hyperkalemia, citrate toxicity). Treatment depends on the type of reaction but may include stopping transfusion, supportive care, and addressing specific causes.
Blood transfusion can cause both immune-mediated and non-immune complications. Immune reactions include acute hemolytic transfusion reactions caused by ABO incompatibility, delayed hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, graft-versus-host disease, and transfusion-related acute lung injury. Non-immune risks are fluid overload, hypothermia, and electrolyte toxicity such as hyperkalemia. It is important to carefully match blood type and screen for antibodies to prevent immune complications of transfusion.
COMPLICATIONS OF BLOOD TRANSFUSION 2016.pptxSesinuModupe
This document discusses complications that can arise from blood transfusions. It describes immunological complications such as hemolytic transfusion reactions, febrile reactions, and graft-versus-host disease. It also discusses non-immunological complications like transfusion of infectious diseases, circulatory overload, and complications of massive transfusions including hypocalcemia and acidosis. The document provides details on identifying, managing, and preventing various transfusion complications.
Indications and complications of blood transfusion abhimanyu_ganguly
Blood transfusions are given to increase oxygen-carrying capacity and intravascular volume. Transfusion is rarely indicated when hemoglobin is above 10 g/dL but is almost always needed below 6 g/dL, with determinations between 6-10 g/dL based on patient risk and evaluation. Complications include changes in oxygen transport, coagulation issues like thrombocytopenia, allergic reactions, lung injury, and immunosuppression. The most common causes of transfusion-related death are bacterial contamination, transfusion-related acute lung injury, and mistransfusion.
This document provides guidelines for blood transfusion, including:
1. It discusses the selection and preparation of blood products such as whole blood, platelet concentrates, fresh frozen plasma, and packed red blood cells. Proper donor requirements, collection procedures, and storage conditions are outlined.
2. Indications, dosing, and expected responses to transfusions of various blood components are covered. Red blood cell and platelet transfusion thresholds and dosing are provided.
3. Safety procedures for blood typing, cross-matching, and transfusion monitoring are described. Special considerations for patients with conditions like autoimmune hemolytic anemia that could cause transfusion reactions are highlighted.
4. Two case illustrations demonstrate the
1) Blood conservation strategies are important in cardiac surgery to reduce bleeding and transfusions which can increase mortality and morbidity.
2) Preoperative interventions include managing antiplatelet drugs and anticoagulants, correcting anemia, and using drugs to increase red cell mass.
3) Intraoperative techniques involve autologous blood donation, maintaining normothermia, pharmacological agents like tranexamic acid, and restrictive transfusion triggers.
4) Close monitoring of bleeding and vital signs is also important intraoperatively to guide transfusions which should be a last resort.
This document provides an overview of blood transfusion in surgery. It discusses the history of blood transfusion, the components of blood, indications for transfusion, complications of transfusion such as reactions and infections, massive blood transfusion protocols, and current trends. The document outlines the various blood products that can be transfused including red blood cells, platelets, plasma, and cryoprecipitate. It also discusses autologous and allogenic transfusion approaches.
Blood therapy has evolved significantly since the initial attempts at animal-to-human and human-to-human blood transfusions in the 17th century. The discovery of blood groups by Landsteiner in 1900 was a major breakthrough, allowing for safer matching of donor and recipient blood. Modern practices involve component therapy using packed red blood cells, fresh frozen plasma, and cryoprecipitate. While transfusion reactions can occur, attitudes have shifted to reducing unnecessary transfusions through autologous donation and cell salvage techniques.
Blood transfusion and its complication.pptxNishiThawait
Blood transfusion involves transferring blood or blood components from a donor to a recipient. It is a life-saving procedure but can also lead to adverse reactions. Precautions must be taken before transfusion to ensure compatible blood types, including blood grouping, crossmatching, and screening donors for diseases. Potential transfusion complications include acute hemolytic reactions, febrile reactions, allergic reactions, circulatory overload, and infections being transmitted from the donor. Long term issues may also occur like iron overload, graft-versus-host disease, or post-transfusion purpura. Careful patient monitoring during and after transfusion can help manage any reactions.
This document discusses complications that can occur from blood transfusions. It describes various types of immunologic reactions like acute and delayed hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, and post-transfusion purpura. It also discusses infectious complications from transfusions like viruses, bacteria, and other pathogens. Massive blood transfusions are outlined as carrying additional risks such as acidosis, hyperkalemia, citrate toxicity, hypocalcemia, metabolic alkalosis, iron overload, fluid overload, and hypothermia. Prevention strategies and treatment approaches for various complications are provided.
Blood and blood products were presented. Key points included:
1. Blood functions to transport vital substances throughout the body.
2. Blood typing and cross-matching must be done correctly to avoid transfusion reactions.
3. Several blood products exist including packed red blood cells, platelets, and plasma derivatives that are used to treat different conditions.
4. Blood transfusions can have complications and must only be done when necessary following all safety protocols.
This document summarizes information about blood transfusions. It discusses the history and development of blood transfusions, indications for transfusions, blood grouping and compatibility testing, potential complications, available blood components, and safe transfusion procedures. The presenter provides an overview of topics related to blood transfusions including donor screening, storage and handling of blood products, monitoring for side effects, and documentation of the transfusion process.
Blood and blood products can be used to treat various medical conditions. Whole blood contains red blood cells, white blood cells, platelets, and plasma. It is used to treat acute blood loss. Other blood products include packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. These treat specific deficiencies or conditions. Potential complications of transfusion include acute lung injury, circulatory overload, hemolytic reactions, allergic reactions, anaphylaxis, sepsis, and delayed reactions. Careful patient monitoring during and after transfusion can help reduce risks.
ADVERSE EFFECTS OF BLOOD TRANSFUSION.pptxdipyapatho
Adverse transfusion reactions:Adverse transfusion reactions are unwanted or harmful responses that can occur as a result of receiving a blood transfusion. While blood transfusions are generally safe, adverse reactions can happen in some cases. Here are some common types of adverse transfusion reactions in the presentation
This document discusses various types of transfusion reactions, their causes, signs and symptoms, investigations, management, and prevention. It describes hemolytic transfusion reactions caused by ABO incompatibility or other antibodies which can be acute and life-threatening or delayed. Non-hemolytic reactions include febrile non-hemolytic reactions, allergic reactions, anaphylaxis, circulatory overload, and graft-versus-host disease. Investigations of transfusion reactions include blood samples, urine analysis, and cultures to identify the cause and guide appropriate treatment.
Transfusion reactions can occur during or after blood transfusion and range from mild to life-threatening. The major causes are misidentification of patient, blood or sample, or administration errors. Reactions can be infectious, from pathogens in blood, or non-infectious, which include immune reactions (e.g. hemolytic), non-immune reactions (e.g. transfusion-associated circulatory overload), or errors in storage or administration (e.g. hypothermia, hyperkalemia, citrate toxicity). Treatment depends on the type of reaction but may include stopping transfusion, supportive care, and addressing specific causes.
Blood transfusion can cause both immune-mediated and non-immune complications. Immune reactions include acute hemolytic transfusion reactions caused by ABO incompatibility, delayed hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, graft-versus-host disease, and transfusion-related acute lung injury. Non-immune risks are fluid overload, hypothermia, and electrolyte toxicity such as hyperkalemia. It is important to carefully match blood type and screen for antibodies to prevent immune complications of transfusion.
COMPLICATIONS OF BLOOD TRANSFUSION 2016.pptxSesinuModupe
This document discusses complications that can arise from blood transfusions. It describes immunological complications such as hemolytic transfusion reactions, febrile reactions, and graft-versus-host disease. It also discusses non-immunological complications like transfusion of infectious diseases, circulatory overload, and complications of massive transfusions including hypocalcemia and acidosis. The document provides details on identifying, managing, and preventing various transfusion complications.
Indications and complications of blood transfusion abhimanyu_ganguly
Blood transfusions are given to increase oxygen-carrying capacity and intravascular volume. Transfusion is rarely indicated when hemoglobin is above 10 g/dL but is almost always needed below 6 g/dL, with determinations between 6-10 g/dL based on patient risk and evaluation. Complications include changes in oxygen transport, coagulation issues like thrombocytopenia, allergic reactions, lung injury, and immunosuppression. The most common causes of transfusion-related death are bacterial contamination, transfusion-related acute lung injury, and mistransfusion.
This document provides guidelines for blood transfusion, including:
1. It discusses the selection and preparation of blood products such as whole blood, platelet concentrates, fresh frozen plasma, and packed red blood cells. Proper donor requirements, collection procedures, and storage conditions are outlined.
2. Indications, dosing, and expected responses to transfusions of various blood components are covered. Red blood cell and platelet transfusion thresholds and dosing are provided.
3. Safety procedures for blood typing, cross-matching, and transfusion monitoring are described. Special considerations for patients with conditions like autoimmune hemolytic anemia that could cause transfusion reactions are highlighted.
4. Two case illustrations demonstrate the
1) Blood conservation strategies are important in cardiac surgery to reduce bleeding and transfusions which can increase mortality and morbidity.
2) Preoperative interventions include managing antiplatelet drugs and anticoagulants, correcting anemia, and using drugs to increase red cell mass.
3) Intraoperative techniques involve autologous blood donation, maintaining normothermia, pharmacological agents like tranexamic acid, and restrictive transfusion triggers.
4) Close monitoring of bleeding and vital signs is also important intraoperatively to guide transfusions which should be a last resort.
This document provides an overview of blood transfusion in surgery. It discusses the history of blood transfusion, the components of blood, indications for transfusion, complications of transfusion such as reactions and infections, massive blood transfusion protocols, and current trends. The document outlines the various blood products that can be transfused including red blood cells, platelets, plasma, and cryoprecipitate. It also discusses autologous and allogenic transfusion approaches.
Blood therapy has evolved significantly since the initial attempts at animal-to-human and human-to-human blood transfusions in the 17th century. The discovery of blood groups by Landsteiner in 1900 was a major breakthrough, allowing for safer matching of donor and recipient blood. Modern practices involve component therapy using packed red blood cells, fresh frozen plasma, and cryoprecipitate. While transfusion reactions can occur, attitudes have shifted to reducing unnecessary transfusions through autologous donation and cell salvage techniques.
This document provides an overview of gastroenterology and esophageal diseases, covering symptoms, diagnostic tools, disease pathophysiology, management, and prevention strategies. Key topics discussed include gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal cancer, achalasia, and other esophageal motility disorders. Treatment options are presented for various stages of esophageal cancer.
This document discusses the role of ultrasound in obstetrics. It outlines the various uses of ultrasound in the 1st, 2nd, and 3rd trimesters of pregnancy, including confirming viability, dating the pregnancy, screening for abnormalities, assessing fetal growth, and evaluating fetal well-being. Ultrasound can be used to locate intrauterine pregnancies, diagnose twins and other masses, and guide procedures. While it poses no radiation risk, the effects of high-powered ultrasound are still theoretical.
Pelvic inflammatory disease (PID) is an infection of a woman's reproductive organs that spreads from the cervix to the uterus, fallopian tubes, ovaries, and surrounding structures. Common causes are sexually transmitted infections like gonorrhea and chlamydia. Symptoms include lower abdominal pain, vaginal discharge, fever and painful sex. Investigations may include blood tests and ultrasounds. Complications can include infertility, ectopic pregnancy, chronic pelvic pain if scar tissue forms. Treatment involves antibiotics and sometimes surgery. Prevention focuses on safe sex practices and screening/treating STIs.
Preoperative and Postoperative management.pptYousifAhmedDA
Preoperative evaluation is one of important thing in managing a successful operation without it ,a pateint may encounter life threating condition during or after surgery
Group A strep can cause pharyngitis, which in rare cases can lead to acute rheumatic fever and rheumatic heart disease. Rheumatic fever is an autoimmune response following a strep throat infection, causing inflammation in joints, heart valves, and other tissues. It affects children primarily in developing countries. Prompt diagnosis and treatment of strep throat is key to preventing rheumatic fever. Rheumatic heart disease is permanent heart damage from repeated rheumatic fever attacks and is the most severe consequence, with symptoms depending on the valves affected. Control programs aim to prevent rheumatic fever through strep throat screening, treatment and public awareness.
Complications of blood transfusions, blood transfusion is a life saving and life threating procedure, so it's important to anticipate blood transfusion reaction
Pelvic inflammatory disease is an infection of a woman's reproductive organs. It is a complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that are not sexually transmitted can also cause PID
Pelvic inflammatory disease (PID) is a clinical syndrome caused by the ascending spread of microorganisms from the vagina or cervix to the female reproductive organs. It affects approximately 750,000 women in the US annually and costs over $4.2 billion to treat. Risk factors include a history of sexually transmitted infections like gonorrhea or chlamydia. Diagnosis involves examining for cervical motion tenderness, uterine tenderness, or adnexal tenderness. Treatment aims to provide broad-spectrum antibiotic coverage and is most effective when started early to prevent long-term complications like infertility. Prevention strategies center around screening and treatment of sexually active women for chlamydia and gonorrhea as well as treating male partners
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
3. LEARNING OUTCOMES
At the end of this topic, you should able to:
• Understand concept of Whole blood and blood
components
• Discuss types and indications of blood transfusion
• Enlist tests to be performed prior to blood transfusion
• Understand transfusion reactions and their
managements.
4. Blood Transfusion
• Process of transferring blood-based products from one person into
the circulatory system of another through an intravenous line.
• The appropriate use of blood means the transfusion of safe blood
products only to treat a condition leading to significant morbidity or
mortality that cannot be prevented or managed effectively by other
means.
• Transfusion carries the risk of adverse reactions and transfusion-
transmitted infection. Plasma can transmit most of the infections
present in whole blood and there are very few indications for its
5. TRANSFUSION
THERAPY
* REPLACEMENT
* THERAPEUTIC
1.To restore intravascular volume
with whole blood or albumin.
2. To restore the oxygen capacity
of blood by replacing red blood
cells.
3. To replace clotting factor and
correction of anemia
PURPOSE OFBLOOD
6. Blood safety
transfusion-transmissible infection
window period : is the period during the development of a new
infection in a previously non-infected person in which the person’s
blood may be very infectious, but the detectable antibody has not yet
appeared.
7. WHOLE BLOOD AND BLOOD COMPONENTS
• 350ml /450 ml of blood is collected from a donor into a
plastic bag containing an anticoagulant
• This is called 1 “unit” of whole blood
• Types of blood components:-
• Red blood cell concentrate (packed red blood cells)
• Platelet concentrate
• Fresh frozen plasma Cryoprecipitate
Plasma or platelets collected by apheresis.
Apheresis: a method of collecting plasma or platelets directly from
the donor, usually by a mechanical method
10. Effects of storage on whole blood
■ Reduction in the pH (blood becomes more acidic)
■ Rise in plasma potassium concentration (extracellular K+)
■ Progressive reduction in the red cell content of 2,3 diphosphoglycerate
(2,3 DPG) which may reduce the release of oxygen at tissue level until
2,3 DPG is restored
■ Loss of all platelet function in whole blood within 48 hours of donation
■ Reduction in Factor VIII to 10–20% of normal within 48 hours of
donation. Coagulation factors such as VII and IX are relatively stable in
storage
11. TYPES OF BLOOD TRANSFUSION
• FRESH BLOOD TRANSFUSION
Blood less than 24 hours old from the time of collection
• AUTOLOGOUS TRANSFUSION
Blood collected from a patient for re-transfusion at a later time
into the same individual
• MASSIVE TRANSFUSION
Number of units transfused in a 24 hours period exceeds the
recipient’s blood volume
• MULTIPLE TRANSFUSION
Repeated transfusion of blood over a long period of time
(months or year)
12. INDICATIONS OF BLOOD TRANSFUSION
• Whole Blood:
Storage -4° for up to 35 days
• Acute blood loss (trauma )
• Shock
• Exchange transfusion in neonate
• Considerations
• Use filter as platelets and coagulation factors will not be active
after 3-5 days
• Packed red blood cells:
Storage - 2 – 6 O C
• Chronic severe Anemia
• Leukemia
• Thalassemia
13. • Platelets concentrate:
Platelet viability is optimal at 22° C but storage is limited
to 4-5 days .
1 unit/10 kg of body weight increases Plt count by 50,000
• Thrombocytopenia <15,000
• Bleeding due to platelet dysfunction
• Malignancy
• Major surgery
• Fresh frozen plasma:
Storage FFP-12 months at –18 degrees or colder
• Liver disorders
• DIC
• Coagulation factor deficiency (V, VII)
14. Cryoprecipitate:
Description
Precipitate formed/collected when FFP is thawed at 4°
Storage
After collection, refrozen and stored up to 1 year at -18
• Hemophilia A (Factor VIII or XIII deficiency )
• von Willebrand’s disease
• Fibrinogen deficiency
15. PRE-TRANSFUSION TESTING
• ABO and Rh (D) blood grouping :
• Patient’s and donor’s blood sample
• Cross matching of blood sample:
• Major cross match- Pt’s serum + Donor cells
• Minor cross match- pt’s cells + Donor serum
17. PRE-TRANSFUSION TESTING (contd.)
• Screening for Transfusion transmitted diseases
(Donor Sample)
HIV 1 and 2 AIDS
HBsAg Hepatitis B
HCV Hepatitis C
Treponema pallidum Syphilis
Plasmodium species Malaria
20. CAUSES OF TRANSFUSION REACTIONS
• Clerical errors:
• Inadequate labeling
• Wrong blood issued
• Technical errors:
• Error in blood grouping & cross matching
• Incorrect interpretation of test results
• Others:
• Blood contamination during phlebotomy
• Blood infusion thr’ small bore needle
• Blood cooler to -30⁰C or warmed to > 42⁰ C
• Concomitant administration blood & drugs thr’ common set
21. How to Prevent Errors in the Transfusion Chain
Where in the process do errors occur?
Who is making the errors?
Why are the errors occuring – which elements of good
transfusion practice are failing
Sample Error
Sample Error Technical Error
Technical Error
Wrong Blood
Wrong Blood
Issued
Issued
Storage Error
Storage Error
Patient
Patient
Misidentification
Misidentification
Administrative
Administrative
Error
Error
24. Febrile (non haemolytic) Transfusion Reaction
(FNHTR)
Rise in patient temperature >1°C (associated with transfusion without
other fever precipitating factors
Onset during or within 4 hours following transfusion , Reaction
induced by cytokines.
Occurs with approx 1% of PRBC transfusions and approx 20% of Plt
transfusions
25. • Mild: unexplained fever ≥38°C and a temperature rise of at
least 1°C but <1.5°C from pre-transfusion baseline, occurring in
the absence of chills, rigors, respiratory distress and
haemodynamic instability
• Moderate: unexplained fever ≥38°C and a temperature rise of
at least 1°C but not meeting criteria for either mild or severe
FNHTR
• Severe: unexplained fever >39°C and a temperature rise ≥2.0°C
from pre-transfusion baseline and chills/rigors .
• STOP TRANSFUSION
• Check label and recipient identity
• Slow the transfusion if reaction is mild and MO elects to
continue transfusion
• Antipyretic Paracetamol 1g po and monitor closely
• Steroids are not appropriate treatment for minor reactions
26. Acute Hemolytic Transfusion Reactions
(AHTR)
• Occurs when incompatible RBC’s are transfused into a recipient who has pre-
formed antibodies (usually ABO or Rh)
• Antibodies activate the complement system, causing intravascular hemolysis
• Symptoms occur within minutes of starting the transfusion
• This hemolytic reaction can occur with as little as 1-2 cc of RBC’s
• Labeling error is most common problem
• Can be fatal
27. Signs and Symptoms
• Fever , Chills, rigors
• Nausea and vomiting
• Hypotension and tachycardia (bradykinin)
• Flushed and dyspneic (histamine)
• Chest, abdominal or low back pain (cytokine release)
• Headache
• Haemoglobinaemia and haemoglobinuria
• Oliguria with dark urine or anuria
• Pallor, jaundice - Bleeding (due to DIC)
28. • Stop transfusion
• Check label and recipient identify
• Replace IV set and start normal saline
• Treat shock and maintain blood pressure with IV saline
infusion
• Investigate possible DIC and treat if clinically significant
bleeding
• Diuretic, eg Frusemide 1-2 mg/kg IV and/or Mannitol, may
help maintain urine flow
• Hydrocortisone may be considered
• Samples to assess renal and liver function, DIC and
haemolysis, eg full blood count, unconjugated bilirubin, LDH
and haptoglobin
• Send Haemovigilance notification to Blood Bank
29. Delayed Hemolytic Transfusion
Reactions
• Onset usually 1-7 days post transfusion but may be up to 28
days.
• Worsening anaemia and jaundice from destruction of red cells
Often asymptomatic but rarely splenomegaly,
haemoglobinaemia and haemoglobinuria .
• Renal impairment may occur in severe cases
Investigate haemolysis: Full blood count with film comment
Direct antiglobulin test (may be negative when most red cells
cleared)
Blood group antibody screen (may be negative until red cells
cleared) Liver function tests Haptoglobin concentration
falls while haemolysis is occurring
30. Allergic Transfusion Reactions
Allergic Reaction (minor)
Frequency: 1:100 - 1:500 More common with Plasma and Platelet Components .
Onset: from commencement to 4 hours after transfusion Recipient may have an antibody
reacting with an antigen in the transfused product .
Minor or localised reaction:
Flushed skin
Morbilliform rash with itching
Urticaria (hives)
Angioedema
Periorbital itch, erythema and oedema
Conjunctival oedema
Minor oedema of lips, tongue and uvula
31. Management
Slow transfusion
Check label and recipient identity
Antihistamine, eg Loratadine 10mg or Cetirizine
10mg po if symptoms are troublesome
If symptoms mild and transient, transfusion may
resume
Continue transfusion at a slower rate with increased
monitoring, eg BP/TPR 15 – 30min
Send Haemovigilance notification to Blood Bank
If symptoms increase treat as a moderate or severe
reaction
32. Allergic Reaction (moderate)
Frequency: 1:500–1:5,000
Onset usually within first 50-100 mL infused and within
4 hours of transfusion .
Moderate or widespread reaction:
Symptoms as for minor reactions, and –
Cough
Hypotension and tachycardia
Dyspnoea and oxygen desaturation are common
Chills and rigors
Loin pain and angina
Severe anxiety
33. Management
• Stop transfusion
• Check label and recipient identity
• Replace IV set and give saline to keep vein open and/or
maintain BP
• Monitor closely and treat symptomatically as required
with IV fluids, oxygen and antihistamine, eg
Promethazine 25-50 mg IV (max rate 25 mg/min) or
Loratadine 10mg or Cetirizine 10mg po. Hydrocortisone
may be considered
• Send Haemovigilance notification to Blood Bank
• Discuss with TMS promptly if mod - severe reaction
present
34. Anaphylactic / Anaphylactoid Allergic Reaction (severe)
Frequency: 1:20,000 – 1:50,000
Rapid onset :
- May be due to an antibody in the recipient reacting with a plasma protein in a blood component
- IgA
- Haptoglobin o Other plasma protein.
Life-threatening reaction:
Symptoms as for moderate reactions, and
Severe hypotension, shock and tachycardia
Widespread urticaria with skin flushing and itching
Wheezing, stridor, change in voice
Severe anxiety
35. Management
Stop transfusion
Check label and recipient identity
Follow Anaphylaxis Guidelines:
• Adrenalin 1:1000 IM and repeat at 5- 10 min intervals if required: - Adult:
0.5mg / 0.5 mL - Children 0.01mg/kg IM; min dose 0.1mL, max dose 0.5mL
• Replace IV set and give rapid IV colloid or saline, eg adults 2 L, children 20
mL/kg, until SBP>90 mmHg, then titrate
• Consider Hydrocortisone 4mg/kg (200- 400 mg IV)
• Consider H1-antihistamine, eg Loratadine or Cetirizine 10 mg po for itch or
angioedema.
• H2-antihistamine, eg Ranitidine may be added for severe reactions.
• Note: Sedating antihistamines, eg Promethazine contraindicated
CPAP ventilation, chest X-ray
ICU liaison
Discuss severe reactions with TMS
36. TRALI: Transfusion Associated Lung Injury
• Frequency: <1:5,000
• Onset within 6 hours following transfusion of plasma or plasma-
containing cellular components
• A complex group of disorders indistinguishable clinically from ARDS
• One recognised mechanism involves a donor antibody reacting with
recipient neutrophil- or HLA-antigens causing cell activation that
results in acute severe microvascular lung injury .
37. • Onset of severe dyspnoea and cyanosis proceeding to
respiratory failure with bilateral infiltrates on CXR within 6
hours of transfusion .
• Absence of left atrial hypertension (circulatory overload)
Distinguish from:
cardiovascular overload (TACO) o
other causes of acute respiratory distress syndrome (ARDS)
or less severe acute lung injury (ALI)
Management
- Intensive care management for respiratory failure
- Diuretics are not usually helpful
38. TACO: Transfusion Associated
Circulatory Overload
• Rapid onset after infusion of a volume of fluid that is clinically
significant for the affected recipient.
• Main risk factors: premature/ new borne or Elderly patients
recipient with impaired cardiovascular state or renal impairment o
Infusion too rapid for recipient o Volume infused too great, especially
if normovolaemic.
• Clinics: Acute heart failure
Prophylaxis: Slow infusion rate, low volume of transfusion
39. Increased blood pressure
Rapid bounding pulse
Respiratory distress with raised resp. rate, dyspnoea, cough, pink
frothy sputum, crepitations and oxygen desaturation consistent with
pulmonary oedema
Raised JVP and CVP
Nausea
Acute or worsening pulmonary oedema on CXR
Restlessness, anxiety
Management
Stop transfusion
Seek urgent medical assessment
Sit recipient upright with legs over side of bed, administer oxygen,
diuretic (Frusemide 1-2 mg/kg IV), CPAP ventilation.
Demonstration of raised BNP may help to distinguish from TRALI
41. Bacterial Contamination(Bacterial Sepsis)
• More common and more severe with platelet transfusion (platelets are stored at room
temperature)
• Organisms
• Platelets—Gram (+) organisms, ie Staph/Strep
• RBC’s—Yersinia, enterobacter
Symptoms :
- Rigor, chills, fever
-Shock, usually within minutes of starting transfusion
-Respiratory distress, wheezing and oxygen desaturation
-Pain up arm , Chest and back / loin pain Nausea,
Give antibiotics: a broad-spectrum penicillin or cephalosporin and gentamicin 5mg/kg.
42. Cooling
Progressive onset during rapid infusion of large
volumes of cold fluids, including blood products (more
than 50 mL/kg/h in adults or 15 mL/kg/h in children.
Signs And Symptoms
• Reduced temperature
• May be associated with cardiac rhythm irregularity and
a negative inotropic effect
• Impaired platelet function and coagulation
Limit heat loss from the recipient and monitor BP/TPR
If further blood components required, infuse through a
warmer
43. Chronic Transfusion Reactions
oAlloimmunization
oTransfusion Associated Graft Verses Host Disease (GVHD)
oIron Overload
oTransfusion Transmitted Infection
oPost Transfusion Purpura :
(Onset about 5-12 days after transfusion of cellular blood components ,
• Severe thrombocytopenia often with purpura and possibly other
bleeding .
• Thrombocytopenia will persist for 1-2 weeks
47. General managements of Acute transfusion reactions
• category 1: Mild reactions
• Urticaria and itching are not uncommon reactions following transfusion. They arise as a result of
hypersensitivity with local histamine release to proteins, probably in the donor plasma.
• Signs and symptoms
• Localised cutaneous reactions (urticaria and rash), often accompanied by pruritus (intense itching), occur
within minutes of commencing the transfusion. The symptoms usually subside if the transfusion is slowed
and antihistamine is given.
Management
1- Slow the transfusion.
2 -Give an antihistamine: e.g. chlorpheniramine 0.1 mg/kg by intramuscular injection.
3- Continue the transfusion at the normal rate if there is no progression of symptoms after 30 minutes.
4- If there is no clinical improvement within 30 minutes or if signs and symptoms worsen, treat the reaction as
a Category 2 reaction.
48. Category 2: Moderately severe reactions
Signs and symptoms usually occur 30–60 minutes after the start of the transfusion.
Signs
■ Flushing Urticaria
■
■ Rigor Fever
■
■ Restlessness Tachycardia
■
Symptoms
■ Anxiety Pruritus (itching)
■
■ Palpitation Mild dyspnoea
■
■ Headache
49. 1- Stop the transfusion. Replace the infusion set and keep the IV
line open with normal saline.
3- Administer antihistamine IV or IM (e.g. chlorpheniramine
0.01 mg/kg or equivalent) and an oral or rectal antipyretic (e.g.
paracetamol 10 mg/kg: 500 mg – 1 g in adults). Avoid aspirin in
thrombocytopenic patients.
4- Give IV corticosteroids and bronchodilators if there are
anaphylactoid features (e.g. broncospasm, stridor).
5- Collect urine for the next 24 hours for evidence of haemolysis
and send to the laboratory.
6- If there is a clinical improvement, restart the transfusion
slowly with a new unit of blood and observe carefully.
51. Symptoms
■ Anxiety
■ Chest pain
■ Respiratory distress/shortness of breath
■ Loin/back pain
■ Headache
■ Dyspnoea
Management
1- Stop the transfusion and Check label and recipient identity
- Replace the infusion set and keep IV line open with normal saline.
2- Infuse normal saline to maintain systolic BP (initial 20–30 ml/kg).
If hypotensive, give over 5 minutes and elevate patient’s legs.
3- Maintain airway and give high flow oxygen by mask.
52. 4 -Give 1:1000 adrenaline 0.01 mg/kg body weight by
intramuscular injection.- Children 0.01mg/kg IM; min
dose 0.1mL, max dose 0.5mL
5- Give IV corticosteroids ( Consider iv Hydrocortisone
4mg/kg (200- 400 mg ) and bronchodilators if there
are anaphylactoid features (e.g. broncospasm,
stridor).
6 -Give diuretic: e.g. frusemide 1 mg/kg IV or
equivalent
7- Consider H1-antihistamine, eg Loratadine or
Cetirizine 10 mg po for itch or angioedema.
o H2-antihistamine, eg Ranitidine may be added for
severe reactions.
53. Reference
• American Society of Hematology 2021 L Street NW, Suite 900
Washington, DC 20036
• www.hematology.org
• 2012 Clinical Practice Guide on Red Blood Cell Transfusion
• Handbook of Transfusion Medicine. Fourth Edition.
www.transfusionguidelines.org.uk
55. Case 1
Mr gulled is a 14 year old male is brought to
the ER after a motor vehicle accident. He is in
pain, tachycardic to 120s, but normotensive.
• Given his acute blood loss, transfusion of 1u
PRBC is initiated (after appropriate type and
cross-matching revealing no antibodies, and
compatibility with donor blood).
• During transfusion, he develops a fever but
otherwise has no new signs or symptoms.
• What is the diagnosis?
57. Case 1 (continued)
• Mr gulled does well following discharge. Fifteen years
later (age 29 ), however, he is unfortunately in a
second MVA. He is brought to the ER, again requiring
blood products.
• He is type and cross-matched, found to have no
antibodies. He is pre-treated with acetaminophen,
and transfused 2 units PRBC without issue.
• The remainder of his hospital course is unremarkable
and the pt is discharged home.
• Ten days after the accident he follows up at his PCP’s
office with a complaint of fatigue, fevers, and
yellowing of his skin.
• What is the diagnosis?
59. Case 1 (continued)
• Mr gulled is now 78 years old. Since we
last saw him, he has been diagnosed
with diabetes, complicated by ESRD 2/2
diabetic nephropathy for which he is
dialyzed three times per week.
• He is admitted for a suspected GI bleed
for which he is transfused 2 units PRBC.
An hour after transfusion, he starts to
complain of shortness of breath and
chest tightness. HR 120s, BP 180/90, an
S3 gallop is noted, and new bibasilar
crackles are heard on pulmonary exam.
Post-transfusion CXR is shown (was
previously normal).
• What is the diagnosis?
https://www.med-ed.virginia.edu/courses/
rad/cxr/pathology2chest.html
61. What is The Most Likely Diagnosis
A) Pulmonary Embolism
B) Transfusion Related Acute Lung Injury
C) Transfusion Associated Circulatory Overload
D) Anaphylaxis
E) Acute Respiratory Distress Syndrome
More common than TRALI (1 in 100 vs 1 in 10,000). This case was confirmed
to be TACO.
PE usually causes respiratory alkalosis with hypoxia on ABG.
Anaphylaxis should be considered but TACO is more likely in this scenario.
ARDS is less likely given no evidence of infection or inflammation prior to the
sudden event.
63. Case 3. Back to Mr gulled…
• Mr gulled is now 80 years old and is admitted after a fall during which
he sustained a left hip fracture. Following surgery, he requires 1 unit
PRBC. He is appropriately type and crossmatched, pretreated with
acetaminophen, and a slow transfusion is initiated during dialysis.
During the transfusion, he develops diffuse urticaria but is otherwise
stable.
• What is the diagnosis?
umm.edu