ABSTRACT
Background: Common obstetric emergencies require blood and blood components transfusion. The use of blood and its components has become a lifesaving strategy in management of obstetric haemorrhage. This study was aimed to know the prevalence, indications and adverse reactions of blood and its components transfusion.Methods: A review of 405 patients of obstetric emergencies requiring blood and its component transfusion was done.Results: Prevalence of blood and blood components transfusion in obstetric emergencies in one-year period was 18.4%. Mostly women who received blood transfusions were multiparous (50.12%) and belonged to rural areas (62%). Anemia is a risk factor for obstetric emergencies and the mean pre transfusion hemoglobin ±SD was 8.04±1.38 (g/dl). Obstetric hemorrhage (68.6%) was the most common indication for transfusion and packed red cells were most commonly (54.07%) transfused. The overall percentage of adverse reactions seen during transfusion was 1.95%.Conclusions: The present study reinforces the importance of appropriate use of blood and its components in obstetric emergencies. Appropriate use of blood components avoids many of the hazards associated with use of whole blood. All blood components should be made available at peripheral hospitals as most of the patients require specific blood component and they are referred to tertiary care centre in emergencies which can be avoided.
ABSTRACT
El daño pulmonar agudo relacionado con la transfusión o TRALI, como más comúnmente se le conoce, por definición no se diferencia de otros tipos de distrés respiratorios, salvo por su origen demostrable y su estrecha relación temporal con la transfusión. Constituye una de las reacciones adversas más peligrosas del uso de productos sanguíneos y sus peculiares características le permiten enmascararse entre los muchos factores que pueden desencadenar un daño pulmonar agudo, especialmente en algunos pacientes que resultan más susceptibles a su desarrollo. El propósito de esta revisión es hacer un recordatorio de su existencia, sobre todo a aquellos médicos que manejan cotidianamente pacientes demandantes de componentes sanguíneos y cuya condición clínica favorece su aparición. Sus principales variables epidemiológicas (ej: incidencia y mortalidad) varían, a veces de manera notable, entre los distintos informes. La heterogeneidad de criterios aun después de la consecución de consensos internacionales para su diagnóstico, dificulta aprovechar al máximo los datos obtenidos de los distintos estudios realizados sobre su comportamiento y ha promovido la aparición de no pocos resultados contradictorios. Su diagnóstico clínico representa un reto al presentarse en medio de contextos clínicos que hacen plantear otras causas para la aparición del distrés respiratorio. Por ello, muchas veces pasa inadvertido o es mal identificado(AU)
Transfusion-related acute lung injury better known as TRALI, has not differences with other kinds of acute respiratory distress, except for its close relation with transfusion. It is considered among the greatest hazards on blood products use. With its peculiar characteristics it mimics within the many factors that may trigger an acute respiratory distress, especially among those patients at high risk for suffering lung damage after transfusion. The main purpose of this review is to make a recall of the existence of TRALI for those physicians who deal with high transfusion-demanding patients or those with conditions which could represent a risk for its development. TRALI´s main epidemiological variables (such as incidence and mortality) show important variations among different investigations. The criteria heterogeneity, even after the consecution of international diagnostic consensus, has made it difficult to take advantage of the data arose from multiple studies about its behavior, promoting the report of not a few contradictory results on worldwide publications. Diagnosing TRALI represents a real challenge for the clinician since it often appears within the context of various possible causes for an acute respiratory distress. This is why TRALI is frequently overlooked or misdiagnosed(AU)