Health care professionals administer approximately 40,000 units of blood each day in hospitals around the United States, according to the professional blood banking organization AABB. Blood transfusions often prove life-saving. Serious side effects and complications known as transfusion reactions, however, may occur. Medical personnel responsible for administering blood monitor the patient closely for signs or symptoms of a transfusion reaction. Manifestations of a possible transfusion reaction frequently necessitate immediate discontinuation of blood administration.
Shortness of Breath
Development of shortness of breath during blood administration may indicate a serious reaction and typically requires discontinuation of the transfusion. Shortness of breath may indicate a severe, allergic transfusion reaction with swelling of the airway and wheezing. This type of reaction, known as anaphylaxis, requires immediate medical intervention. Anaphylactic transfusion reactions occur in approximately one out of every 30,000 transfusions, reports the medical information website ClinLab Navigator.
An acute hemolytic transfusion reaction can also provoke shortness of breath during blood administration. With this type of transfusion reaction, antibodies in the recipient's bloodstream destroy the donated red blood cells almost immediately upon reaching the circulation. An acute hemolytic transfusion reaction most commonly occurs when a clerical error leads to administering the wrong blood type to the patient, reports The Merck Manuals Online Medical Library. Patients suffering an acute hemolytic transfusion reaction may develop kidney failure. In rare instances, this type of transfusion reaction proves fatal.
Fever and Chills
The development of fever and chills during blood administration may signal an acute hemolytic transfusion reaction, necessitating immediate discontinuation of the infusion, reports the National Heart Lung and Blood Institute. For the purposes of transfusion monitoring, an increase in body temperature of more than 2 degrees F over the pretransfusion temperature constitutes a fever, reports blood bank specialist Linda Walton on the AABB website.
Falling Blood Pressure and Increased Heart Rate
Falling blood pressure and an increased heart rate may indicate the evolving development of shock. These symptoms prove common with an acute hemolytic transfusion reaction, reports the University of Michigan Department of Pathology. Cold, clammy skin typically accompanies other cardiovascular symptoms in patients developing shock. Administration of large volumes of intravenous fluid helps flush the circulation and reduce the risk of potential kidney damage associated with an acute hemolytic transfusion reaction, according to The Merck Manuals Online Medical Library.
Patients experiencing an anaphylactic transfusion reaction also commonly exhibit falling blood pressure, an increased heart rate and cardiovascular shock. Serious heart rhythm abnormalities may develop. Patients in shock may lose consciousness. In cases of severe shock, cardiac arrest may occur. Steroids and epinephrine prove the mainstay of treatment for an anaphylactic transfusion reaction.
References
- AABB: Blood FAQ
- ClinLab Navigator: Risks of Transfusion
- The Merck Manuals Online Medical Library: Complications of Transfusion
- AABB: Blood Transfusion Administration and Adverse Reactions
- University of Michigan Department of Pathology: Blood Bank and Transfusion Services, 7 Adverse Reactions to Transfusion
