Acute transfusion reactions in critically ill children

作者：Demirkol Demet^*; Karabocuoglu Metin; Kelesoglu Fatih Mehmet; Ozata Nurhan; Citak Agop

来源：Turkish Archives of Pediatrics, 2010, 45(4): 348-352.

DOI：10.4274/tpa.45.348

• Acute transfusion reaction
• critically ill child
• febrile non hemolytic reaction
• pediatric intensive care unit

Aim: This study was undertaken to determine the incidence and type of acute transfusion reactions in a pediatric intensive care unit.
Material and Method: The patients admitted to our pediatric intensive care unit between February 2006 and February 2007 were prospectively recorded. A bedside nurse recorded the patients' vital signs before, during and up to 4 hours after the transfusions.
Results: A total of 762 transfusions were administered to 219 patients during the study period. Acute transfusion reactions were diagnosed in 17.8% (n=38) of transfusions in critically ill children. Acute transfusion reactions incidence rate was found as 4.9% (38/762). All the acute transfusion reactions were febrile non hemolytic reactions. Febrile non hemolytic reactions were associated 68% (n=26) with red blood cell transfusions, 21% (n=8) with platelet transfusions and 3.7% (n=4) with intravenous immunoglobulin transfusions. Overall 8% (n=8) of platelet, 6.1% (n=26) of red blood cell and 3.7% (n=4) of immunoglobulin infusions were involved in febrile non hemolytic reactions. Transfusions were repeated in 52% (n=116) of patients. Acute transfusion reactions incidence rate was found 9% (n=11) in multiple transfusions. There was significant association between acute transfusion reactions and multiple transfusions (p=0.006).
Conclusions: Febrile non hemolytic reactions occur frequently in critically ill pediatric patients who require transfusions. The acute transfusion reaction risk increases with multiple transfusons. The surveillance of transfusions given to pediatric intensive care patients enhances the knowledge about the incidence, type, risk factors and the safety standard required for transfusions. (Turk Arch Ped 2010; 45: 348-52)

• 出版日期2010-12