๐Ÿฉธ Chapter 523 ยท Risks of Blood Transfusions

Nelson Textbook of Pediatrics 22nd Edition | Transfusion risks: infectious (HIV 1:2M, HBV 1:2M, HCV 1:2M, bacteria in platelets 1:100,000, CMV, emerging infections) and non-infectious (acute hemolytic reaction, febrile non-hemolytic, allergic, TRALI, TACO, TA-GVHD, iron overload, immunomodulation, post-transfusion purpura). Prevention: leukoreduction, irradiation, pathogen reduction, strict donor screening.

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๐Ÿ“‹ 30 Clinical Scenarios โ€” Transfusion Risks

๐Ÿ“‡ Highโ€‘Yield Review Cards (Transfusion Risks)

๐Ÿฉบ Clinical Scenarios: Transfusion Reactions

Select a transfusion reaction for diagnosis and management.

๐Ÿ“‹ Stepwise Management of Transfusion Reactions

๐Ÿ”‘ Key Principles โ€” Nelson Chapter 523
โ€ข Immediate reaction (within minutes-hours): Stop transfusion immediately. Assess for acute hemolytic reaction, bacterial contamination, allergic/anaphylaxis, TRALI, TACO.
โ€ข Febrile non-hemolytic reaction: Temperature rise โ‰ฅ1ยฐC without hemolysis. Common with platelet transfusions. Premedicate with acetaminophen.
โ€ข Acute hemolytic reaction: ABO incompatibility. Symptoms: fever, pain, dark urine, hypotension, DIC. Send post-reaction sample to blood bank.
โ€ข TRALI (transfusion-related acute lung injury): Respiratory distress within 6 hours, hypoxia, bilateral infiltrates, no evidence of TACO. Supportive care.
โ€ข TACO (transfusion-associated circulatory overload): Pulmonary edema due to volume overload. Slow transfusion, diuretics.
โ€ข TA-GVHD: Fever, rash, diarrhea, pancytopenia 1-6 weeks after transfusion. Prevent by irradiation of cellular products.

    โšก Reflex Prompts โ€” Clinical Decisions in Transfusion Reactions

    ๐Ÿ“– Summary: Risks of Blood Transfusions โ€” Nelson Chapter 523