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烧伤患者急性输血不良反应模式:巴基斯坦国家烧伤中心一项关于血液警戒的新举措

Pattern of Acute Adverse Transfusion Reactions in Patients With Burn Injuries: A Novel Initiative Towards Haemovigilance at the National Burn Centre of Pakistan.

作者信息

Rehan M, Iqbal T, Sarwar M, Khan M S, Tariq M H, Ain Q, Waheed U

机构信息

Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.

出版信息

Ann Burns Fire Disasters. 2023 Sep 30;36(3):261-265. eCollection 2023 Sep.

Abstract

The transfusion of blood and blood components is a life-saving medical procedure, however, it is linked with adverse reactions to transfusions. Information about different types of adverse transfusion reactions (ATRs) will assist in their early identification and subsequent management, as well as in devising strategies to minimize the occurrence of adverse reactions related to blood component transfusion. The current study was therefore executed to analyze the pattern of ATRs in patients with burn injuries at a national burn center. This was a cross-sectional, prospective study involving an analysis of immediate ATRs from January 2020 to June 2021 (18 months). ATRs observed during the study period were documented and analyzed. During the study period, 2,220 units of blood and blood components were transfused to 1,075 burn patients (2.06 transfusions per patient). A total of 27 ATRs were recorded (1.21%). Allergic reactions were the commonest (55.55%) followed by febrile non-haemolytic transfusion reaction (37.03%). The mean volume of blood unit transfused, when the reactions were noted, was approximately 75 ml (range: 15-230 ml). The mean time at which transfusion reactions were noted was 17 min (range: 5-220 minutes). The ATRs were more common in patients with multiple transfusions compared to those receiving a single transfusion. The common adverse reactions were allergic and febrile non-haemolytic transfusion reactions. It is vital to report all transfusion reactions to the attached blood center and hospital transfusion committee (HTC) on standardized reporting forms. Continuous medical education through seminars and sensitization workshops will support consolidating haemovigilance systems.

摘要

输血及血液成分输注是一种挽救生命的医疗程序,然而,它与输血不良反应相关。了解不同类型的输血不良反应(ATRs)将有助于早期识别及后续处理,以及制定策略以尽量减少与血液成分输注相关的不良反应的发生。因此,本研究旨在分析一家国家烧伤中心烧伤患者的输血不良反应模式。这是一项横断面前瞻性研究,对2020年1月至2021年6月(18个月)期间的即时输血不良反应进行分析。对研究期间观察到的输血不良反应进行记录和分析。在研究期间,共向1075名烧伤患者输注了2220单位的血液及血液成分(每位患者平均输血2.06次)。共记录了27例输血不良反应(1.21%)。过敏反应最为常见(55.55%),其次是发热性非溶血性输血反应(37.03%)。出现反应时输注的血液单位平均量约为75毫升(范围:15 - 230毫升)。出现输血反应的平均时间为17分钟(范围:5 - 220分钟)。与接受单次输血的患者相比,多次输血的患者更容易出现输血不良反应。常见的不良反应是过敏反应和发热性非溶血性输血反应。通过标准化报告表格向附属血液中心和医院输血委员会(HTC)报告所有输血反应至关重要。通过研讨会和宣传讲习班进行持续医学教育将有助于巩固血液警戒系统。

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Transfusion reactions: prevention, diagnosis, and treatment.输血反应:预防、诊断和治疗。
Lancet. 2016 Dec 3;388(10061):2825-2836. doi: 10.1016/S0140-6736(15)01313-6. Epub 2016 Apr 12.

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