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

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.

La transfusion de sang et de ses dérivés peut être salvatrice mais aussi être responsables d ‘effets indésirables (EI). Les données concernant ces EI permettent de les diagnostiquer et les traiter précocement ainsi que de développer des protocoles destinés à en diminuer la prévalence. Cette étude rétrospective a analysé les EI transfusionnels survenus dans un CTB pakistanais sur une période de 18 mois (janvier 2020- juin 2021). Deux mille deux cent vingt unités ont été transfusées à 1 075 brûlés (2,06/patient). Vingt- sept (1,21%) EI ont été enregistrés. Les plus courantes étaient allergiques (55,55%), suivies des réactions fébriles non hémolytiques (37,03%). Cette réaction survenait à la 17ème minute (5- 220) lorsque 75 mL (15 à 230) avaient été passés. Ils étaient plus fréquents chez les multitransfusés que lors de la première perfusion. Il est crucial de rapporter tout EI au CTS et à l’hémovigilance locaux, sous un format standardisé et d’éduquer prescripteurs et utilisateurs.

Keywords: Pakistan; adverse reaction; blood; burn injury; transfusion.