Duran Joana, Siddique Sulman, Cleary Myra
Duke University, Durham, NC, USA
Department of International Nursing, Cure2Children Foundation, London, UK.
J Pediatr Oncol Nurs. 2014 Jul;31(4):223-229. doi: 10.1177/1043454214532029. Epub 2014 May 2.
Transfusion-related reactions cause unwanted interruptions in blood-product administration and potential complications for patients. The most common reactions are febrile nonhemolytic transfusion reactions (FNHTRs) and allergic transfusion reactions (ATRs). The presence of leukocytes in blood products has been associated with these reactions, and efficacy of leukoreduction in minimizing FNHTRs and ATRs has recently been investigated. In addition, premedication with acetaminophen and diphenhydramine is the most widely used practice in minimizing FNHTRs and ATRs, yet the benefit of this is not supported by research. The aim of this systematic literature review was to evaluate the potential benefits of both of these interventions in minimizing FNHTRs and ATRs and provide recommendations for practice. We found moderate quality evidence with strong recommendations for the practice of leukoreduction in minimizing FNHTRs but not ATRs. We did not find evidence to support the use of premedications in minimizing transfusion-related reactions, and we question the need for this practice in settings where leukoreduction is used.
输血相关反应会在血液制品输注过程中造成不必要的干扰，并给患者带来潜在并发症。最常见的反应是发热性非溶血性输血反应（FNHTRs）和过敏性输血反应（ATRs）。血液制品中白细胞的存在与这些反应有关，近期人们对白细胞滤除在减少FNHTRs和ATRs方面的效果进行了研究。此外，使用对乙酰氨基酚和苯海拉明进行预处理是减少FNHTRs和ATRs最广泛采用的做法，但研究并未证实其益处。本系统文献综述的目的是评估这两种干预措施在减少FNHTRs和ATRs方面的潜在益处，并为实践提供建议。我们发现有中等质量的证据，并强烈建议采用白细胞滤除措施来减少FNHTRs，但不能减少ATRs。我们没有找到证据支持使用预处理药物来减少输血相关反应，并且我们质疑在采用白细胞滤除措施的情况下进行这种预处理的必要性。
