Incidentes transfusionais imediatos: revisão integrativa da literatura

Underreporting of transfusion incidents

BACKGROUND

Blood transfusion is an effective therapeutic practice. However, even adopting all procedures for transfusion safety, there are risks, one of which is immediate adverse reactions. The aim of this study was, by active search, to evaluate the occurrence of immediate adverse reactions estimating the occurrence rate within the first 24 h.

METHODS

An exploratory, descriptive, prospective study with quantitative analysis was carried out of patients undergoing surgery who received blood component transfusions during hospitalization from October 2018 to August 2019. Data on blood component request forms were collected from the transfusion agency by reviewing medical records and interviewing the patient or family members. Descriptive statistics and the chi-square test were used to analyze the association of demographic variables with the presence or absence of transfusion reactions.

RESULTS

A total of 1042 blood component units were transfused in 393 transfusions performed on 184 patients. The main transfused blood component was packed red blood cells. Seventeen reactions were identified in the medical records, using the active search method, none of which had been reported. The transfusion reaction rate was 16.3 occurrences per 1000 transfused units, while the notification rate for the 9389 blood component units transfused by the transfusion agency in the study period was 3.83/1000. There was no statistically significant association between the occurrences or not of transfusion reactions and demographic variables.

CONCLUSION

Through the active search method, it was possible to observe the underreporting of adverse reactions, showing inadequate compliance with current legislation, which is essential to minimize errors and increase transfusion safety.

Hemovigilance and patient safety: analysis of immediate transfusion reactions in elderly

OBJECTIVE

To identify immediate transfusion reactions in elders hospitalized in a public hospital in the Federal District.

METHODS

This is an observational, retrospective, documental, and analytical research, with a quantitative analysis of 516 transfusions of packed red blood cells in elders hospitalized in the largest public hospital, who required blood components, from June to December 2017, through descriptive statistics.

RESULTS

The sample corresponded to 46.36% of the total number of transfusions in elders in the period. The mean age was 70 years old. There were adverse effects (reactions to the transfusion) in 12 (2.3%) transfusions. Respiratory alterations (33.3%) and fever (23.8%) were the most common events.

CONCLUSION

The incidence of reactions to the transfusion is below national and international rates, indicating probable undernotification, which could be associated to a lack of knowledge regarding its clinical manifestations and the lack of systematic monitoring of the transfusion.