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BLOOD TRANSFUSION REACTION

BLOOD TRANSFUSION REACTION - BLOOD TRANSFUSION REACTION Non...

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BLOOD TRANSFUSION REACTION Non immunological By Rusmawati bt. Ismail
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Non immunological transfusion reaction 1. Bacterial contamination reactions. 2. Circulatory overload. 3. Transfusion haemosiderosis. 4. Complications of massive transfusion. 5. Non immune hemolytic reaction 6. Disease transmission.
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1. Bacterial contamination reaction. Although uncommon,but this type of specific reaction can have a rapid onset and high mortality in recipients. The presence of bacteria in transfused blood may lead either to febrile reactions in the recipient ( due to pyrogens ) or serious manifestations of septic or endotoxic shock . Commonly caused by endotoxin produced by bacteria capable of growing in cold temperatures such as Pseudomonas species, E. coli, Yersinia enterocolitica .
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Source of infection. Infection of stored blood is extremely rare. Skin contaminants are not infrequently present in freshly donated blood but these organisms ( predominantly staphylococci ) do not survive storage at 4 º C although they will grow profusely in platelet concentrates stored at 22 º C. Healthy donor who are bacteremic at the time of donation . The majority are due to Yersinia enterocolitica , which grows well in red cell components due to its dependence on citrate and Iron. Gram negative, endotoxin – producing contaminants found in dirt, soil and faeces may rarely grow in the storage condition of blood.
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According to CDC , most are caused by blood components contaminated by Yersinia enterocolitica. Since 1987, from 20 cases reported to CDC, 12 are caused by this organism.
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Clinical manifestation Usually appear rapidly during transfusion or within about 30 minutes after transfusion with dryness, flushing of skin. Fever, Hypotension, Chills, Muscle pain, vomiting, Abdominal cramps, Bloody diarrhoea, Hemoglobinuria, Shock, Renal failure, DIC.
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Management. Rapid recognition is essential Immediately stop the transfusion. Therapy of shock, steroids, vassopressors, fluid support, respiratory ventilation and maintenance of renal function. Broad spectrum IV antibiotics The blood component unit and any associated fluids and transfusion equipment should be sent immediately to blood bank for investigation ie: gram stain and culture. Blood C & S from the recepient.
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Prevention Strict adherence to policies & procedures regarding blood component collection, storage, handling,and preparation is essential to reduce the risk. Visual Inspection of components before release from the transfusion service include any discolouration, visible clots, or hemolysis. Ensure the blood components are infused within standard time limits ( 4 hours ).
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Prevention Blood packs should never be opened for sampling, if any open method of preparation has been used, the unit should be transfused within 24 hours.
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