Transfusion reactions, depending on the type, can be very severe, so it is advisable that the transfusion medicine physician or the blood bank specialists are notified whenever a transfusion reaction occurs. It is not uncommon for transfusion medicine specialists to be consulted for help in determining if a change in vital signs during or immediately after a transfusion is significant. In some instances, it can be very difficult to determine whether an observed change in a vital sign represents a normal response to a transfusion or an adverse event.
In a retrospective analysis of blood bank records for 3496 component infusions over a year period, Gehrie et. al sought out to help provide clarity when determining if a change in vital signs represents a normal physiologic response or something more severe. They evaluated recipient pre and post-transfusion vital signs (temperature, systolic blood pressure, diastolic blood pressure, pulse rate) and whether a transfusion reaction was reported for red blood cell transfusions, plasma transfusions, as well as platelet transfusions.
A 0.5% transfusion reaction rate was reported by the clinical teams, but review of vital signs identified 58 additional transfusions that met institutional criteria for a transfusion reaction but were not reported. Transfusions were ultimately associated with very mild changes in temperature (less than 1°), pulse rate (<5 beats/min), and blood pressure (<5 mmHg) across all components. Importantly this work helps shed light on an area that has been previously under-investigated and highlights the fact that transfusion is not associated with significant changes in recipient vital signs.