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Transfusion therapy in injured children
Published in David E. Wesson, Bindi Naik-Mathuria, Pediatric Trauma, 2017
Adverse events related to transfusion are not uncommon, and are likely underreported. The National Healthcare Safety Network reported an overall adverse reactions rate of 0.24% [67]. Transfusion reactions may be broadly classified into nonhemolytic and hemolytic reactions. Nonhemolytic reactions are far more common and most often occur as the result of interactions with plasma proteins or cytokines within the blood component. Of these, allergic and FNHTRs are the most common. Allergic reactions usually include rash, pruritus, urticaria, or localized angioedema mediated by IgE and histamine release [68]. However, these reactions may have more severe manifestations including bronchospasm and anaphylaxis. Patients who have had mild reactions previously may develop more severe reactions over time and should always be carefully monitored for signs of respiratory distress. When an allergic transfusion reaction is suspected, the transfusion should be discontinued and the symptoms managed with antihistamines, epinephrine, and steroids, as indicated. FNHTRs are also common and include the development of fever and/or chills and rigors during the transfusion or shortly thereafter.
Optimal administration strategies of tranexamic acid to minimize blood loss during spinal surgery: results of a Bayesian network meta-analysis
Published in Annals of Medicine, 2022
Ziqin Cao, Qiangxiang Li, Jia Guo, Yajia Li, Jianhuang Wu
Surgery is the only effective option for some end-stage degenerative spinal diseases, such as unstable vertebral fracture, scoliosis and spondylolisthesis. However, the significant perioperative blood loss associated with such procedures leads to an increased risk of complications, including postoperative hypotension, acute anaemia and infection [1,2]. Blood loss also increases the necessity for blood transfusions which incur other side effects, including transmission of infectious diseases, haemolytic reaction, postoperative epidural haematoma of the spinal cord, allergic transfusion reaction and impose an economic burden on health services [3].