Acute transfusion reactions in critically ill pediatric patients

Introduction

This study was undertaken to determine the incidence, type, and severity of acute transfusion reactions observed in a tertiary care pediatric ICU.

Methods

All transfusions of blood product administered to consecutive patients admitted to our pediatric ICU, between February 2006 and February 2007, were prospectively recorded. For each transfusion, the bedside nurse recorded the patient's status before, during, and up to 4 hours after the transfusion, as well as the presence of any new sign or symptom suggesting an acute transfusion reaction.

Results

A total of 651 transfusions were administered during the study period. Sixty-one febrile nonhemolytic transfusion reactions (9.4%) were recorded. No allergic and hypotansive reactions and transfusion-related acute lung injury were seen. Seventy-seven percent (n = 47) of the febrile reactions were recorded during the red blood cell transfusions.

Conclusion

The incidence of febrile nonhemolytic reactions was higher when compared with similar studies. Possible cause may be not using leuko-reduced components. Transfusion-related acute lung injury is not common in critically ill pediatric patients. These estimates are useful for decisions concerning transfusion therapy, and for evaluating efficacy of interventions to reduce risk in critically ill pediatric patients.