FEBRILE NON HAEMOLYTIC TRANSFUSION REACTION — Transcript

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1. 0:01the next transmission reaction i want to
2. 0:04discuss is febrile non-hemolytic
3. 0:07transformation reaction
4. 0:10okay this is a febrile episode in which
5. 0:13the temperature will rise 1 degree
6. 0:15celsius or more during or soon after a
7. 0:19transition
8. 0:20and there is no other obvious cause such
9. 0:23as a hemolytic transmission reaction in
10. 0:26this situation the patient during or
11. 0:28soon after the transition will develop
12. 0:32fever
13. 0:33and then we have excluded all other
14. 0:36causes especially hemolytic transmission
15. 0:39reaction if we have check everything is
16. 0:42okay
17. 0:43then this patient probably is having
18. 0:46febrile non-hemolytic transfusion
19. 0:48reaction when we check the patient the
20. 0:50bp is stable the patient is not in shock
21. 0:54there is no jaundice and there is no
22. 0:57anemia and
23. 0:59the result from the blood bank shows no
24. 1:02incompatibility then probably this
25. 1:05patient will have this rebrand
26. 1:07non-hemolytic transformation reaction
27. 1:09okay usually this will happen associated
28. 1:11with the red cells transfusion in
29. 1:13patients with previous history of
30. 1:15pregnancy and or transfusion
31. 1:18but it also can occur in first time
32. 1:20transfusion after platelet transfusion
33. 1:22in the platelet usually
34. 1:25because we keep platinum at room
35. 1:27temperature so together with the
36. 1:29platelet there are some amount of the
37. 1:31white blood cells in the donor's back so
38. 1:33this white blood cell will produce
39. 1:35always sacred cytokines during the
40. 1:37storage
41. 1:38so during transfusion these preform
42. 1:42cytokines that will infuse together with
43. 1:45the platelet into the patient will cause
44. 1:46the patient to have fever
45. 1:48so this patient will have fever even
46. 1:51though he or she does not have any
47. 1:53previous history of transition before
48. 1:57this cytokine produced after
49. 1:59transcription especially after the red
50. 2:01cells transfusion okay so for example
51. 2:04this patient has been transfused before
52. 2:07with red cells
53. 2:09we must remember even though we give the
54. 2:11patient red cells there are some amount
55. 2:13of white blood cell
56. 2:15in the donor's blood so sometimes when
57. 2:18the white cell also coming into the
58. 2:20patient circulation the body will
59. 2:22recognize that white cell as alien
60. 2:26because they have antigen that the
61. 2:28recipient does not have
62. 2:30so the recipient will produce antibodies
63. 2:33against the white cell of the donor
64. 2:36the second red substitution they will
65. 2:39also have some white cell inside the
66. 2:41donor's blood so the antibodies inside
67. 2:44the recipient will attack the leukocytes
68. 2:47and also produce the cytokines
69. 2:50all right and these cytokines will cause
70. 2:53fever i already explained in a diagram
71. 2:56this is the donor white blood cell the
72. 2:58recipient is already having the antibody
73. 3:01against the donor white blood cell so
74. 3:04the antibody will
75. 3:06attack the white blood cells of the
76. 3:09donor and this will cause the production
77. 3:11of the cytokines such as pyrogens and
78. 3:15these biologists
79. 3:16can cause flushing fever tachycardia and
80. 3:19rykas
81. 3:20okay so if the patient is having fever
82. 3:24first we might need to exclude hemolytic
83. 3:26transmission reaction and if we have
84. 3:28excluded all that and the patient is
85. 3:30stable then probably the patient is
86. 3:33having fibra non-hemolytic transfusion
87. 3:36reaction okay the lead findings are
88. 3:37usually negative what i mean is negative
89. 3:40is there is no anemia
90. 3:42the blue rubin is not high
91. 3:44the patient does not have any antibody
92. 3:46the antibody screening and antibody
93. 3:48identification will still be negative
94. 3:50and the treatment is usually will give
95. 3:52treatment to reduce the fever and
96. 3:55sometimes we can continue the
97. 3:56transfusion with close monitoring