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Canadian Journal of Anesthesia, Vol 8, 492-500, Copyright © 1961 by Canadian Anesthesiologists' Society

Blood Transfusion Reactions during Anaesthesia: A Clinical Study

LEONARD C. JENKINS B.A., M.D., C.M., F.R.C.P.(C.)1 and HORACE B. GRAVES B.A., M.D., C.M.2

1 Department of Anaesthesiology, Vancouver General Hospital, and the University of British Columbia, Vancouver, B.C.
2 Director of Anaesthesiology, Vancouver General Hospital, Clinical Associate Professor of Surgery, Medical Faculty, University of British Columbia, Vancouver, B.C.

Inescapably the anaesthetist is responsible for the decision as to whether or not blood is to be given during the surgical period. That this decision is, indeed, a responsibility, may be seen by the fact that there is an estimated annual death rate of 1 in 1,000 to 3,000 administrations in the U.S.A. This gives a yearly minimum of 1,500 deaths attributable to blood transfusions in the continental United States alone. Moreover, despite increasingly sensitive methods of crossmatching blood and a better knowledge of physlco-chemical factors, a variety of reactions with a 3–5 per cent incidence continue to occur. Unfortunately, they still carry a significant morbidity and mortality rate. Particularly is this true during anaesthesia, where late recognition and management may result because of masked classical clinical presentation. The anaesthetist should be wary when giving blood to patients with any history of previous reaction or known allergies. The more common early reactions are allergic, pyrogenic, haemolytic, and circulatory overload; less common are air embolism, potassium and citrate intoxication, hypothermia, transfusional haemorrhaeic diathesis, and bacterial contamination. Late untoward effects of blood can also occur. These are, mainly, transmission of disease, isQsensitization, and transfusional siderosis. It is significant that all early blood transfusion reactions present key diagnostic clinical manifestations under anaesthesia. These are readily confifmable by simple laboratory procedures. An awareness of these features of blood transfusion reactions during anaesthesia will lead to their prompt recognition and management, thereby reducing morbidity and preventing mortality.

Note:

Presented at the Annual Meeting, Canadian Anaesthetists' Society, May 15–18, 1961.






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Copyright © 1961 by the Canadian Anesthesiologists' Society.