血液疾患と輸血ジャーナル

概要

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

Venkatachalapathy TS

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.