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血液制品输血的不良反应及预防最佳实践

Adverse Reactions to Transfusion of Blood Products and Best Practices for Prevention.

作者信息

Frazier Susan K, Higgins Jacob, Bugajski Andrew, Jones Allison R, Brown Michelle R

机构信息

PhD Program, RICH Heart Program, College of Nursing, University of Kentucky, CON Building, Office 523, 751 Rose Street, Lexington, KY 40536-0232, USA.

College of Nursing, University of Kentucky, CON Building, 751 Rose Street, Lexington, KY 40536-0232, USA.

出版信息

Crit Care Nurs Clin North Am. 2017 Sep;29(3):271-290. doi: 10.1016/j.cnc.2017.04.002. Epub 2017 Jun 26.

Abstract

Transfusion, a common practice in critical care, is not without complication. Acute adverse reactions to transfusion occur within 24 hours and include acute hemolytic transfusion reaction, febrile nonhemolytic transfusion reaction, allergic and anaphylactic reactions, and transfusion-related acute lung injury, transfusion-related infection or sepsis, and transfusion-associated circulatory overload. Delayed transfusion adverse reactions develop 48 hours or more after transfusion and include erythrocyte and platelet alloimmunization, delayed hemolytic transfusion reactions, posttransfusion purpura, transfusion-related immunomodulation, transfusion-associated graft versus host disease, and, with long-term transfusion, iron overload. Clinical strategies may reduce the likelihood of reactions and improve patient outcomes.

摘要

输血是重症监护中的常见操作,但并非没有并发症。输血的急性不良反应发生在24小时内,包括急性溶血性输血反应、发热性非溶血性输血反应、过敏和过敏反应、输血相关急性肺损伤、输血相关感染或败血症以及输血相关循环超负荷。输血延迟不良反应在输血后48小时或更长时间出现,包括红细胞和血小板同种免疫、延迟性溶血性输血反应、输血后紫癜、输血相关免疫调节、输血相关移植物抗宿主病,以及长期输血导致的铁过载。临床策略可能会降低反应的可能性并改善患者预后。

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