A Prospective Audit of Blood Transfusion Reactions in Tertiary Care Hospital for the Use of Blood and Blood Components

Abstract

Aims and Background: Like any other drug, therapeutic use of blood and its components has its own side effects, adverse reactions and risks involved. Overall use of blood has been on the increase in most tertiary care hospitals. Since the guidelines for blood and its components use in a clinical setting are well defined, but not practiced in reality, the present study aims at defining the problems associated with blood transfusion in the light of its risks and benefits as a drug. Materials and Methods:We carried out prospective survey of 1453 units of blood and components for 696 patients during period of 6 months and recorded the indications for usage and transfusion reactions associated with its usage.Results: Out of 1453 units' blood/blood component transfused, 48 (3.30%) units of blood developed transfusion reactions. Of these, 41 were produced by whole blood, (85.41%) & 5 units (10.42%) by packed cells. FFP 1 unit (2.08 %) for a patient with alcoholic liver disease produced reaction. 1 unit of fresh whole blood (2.08%) has produced reaction. Medical cases produced the more number of blood transfusion reactions (14 patients). Most of the blood transfusion reactions were allergic (50%) and most of the reactions were produced after multiple transfusions. Conclusion:There is lack of blood transfusion committee in IGGGH&PGI, Puducherry Hospital, which has produced inappropriate transfusions due to absence of strict transfusion triggers.Transfusion Trigger: Hb% < 7 gms% is an indication for blood transfusion and hematocrit < 27% is an indication. Blood transfusion should be started immediately after its issue from blood bank, if not used within ½ hour and then replaces it to blood bank for cold chain maintenance.Transfusion reactions (3.3%) more common agent is whole blood, since it contains all unnecessary components, which produces allo-immunization.Blood component usage should be increased which will reduce the incidence of transfusion reaction.as yet prior to the discovery of blood group antigens, approximately one third of human transfusions resulted in adverse outcome, often death [4]. With the discovery of blood group antigens in 1901, by Karl Landsteiner, transfusion therapy changed from a hazardous proposition to a relatively safe procedure. Safety from transfusion transmitted diseases improved with advancement of technology. The recent testing facilities have lowered the incidence of transfusion-transmitted diseases to minimum [5]; however, the incidence of adverse events due to human errors [6], ABO incompatibility, alloimmunization, bacterial contamination and immunomodulation phenomena remain a matter of concern.

A Study on Adverse Transfusion Reactions in a Secondary Care Hospital of Rural India

“…Packed Red Blood Cells were more frequently involved in acute transfusion reactions. These results were correlated with the study done by Rajini Bassi et al [8,13,20].…”

A Study on Blood and Blood Components Transfusion, Adverse Reaction at a Tertiary Care Teaching Hospital, Bangalore

“…During the study, O positive blood/blood component units was found to be predominant. These observations were found to be similar with the study conducted by Venkatachalapahy TS [6].…”

“…In surgery department, transfusions post-surgery was found to be more followed by pre-surgery and intra surgery. This was coinciding with the study carried by Venkatachalapahy TS [6].…”

“…In our study, transfusions were found to predominant for female than in male. These gender based differences were coinciding with the observations of Venkatachalapathy TS [6].…”

“…Among these, packed cell transfusion was found to be more in number. These observations were found to be differing from the study conducted by Venkatachalapahy TS [6]. Their results showed whole blood transfusion was predominant.…”