From the Guidelines
Blood transfusion symptoms should be promptly recognized and treated, with a personalized approach tailored to the patient's symptoms and signs to distinguish between febrile and allergic reactions, as recommended by the Association of Anaesthetists guidelines 1. When it comes to blood transfusion symptoms, patients may experience a range of reactions, from mild to severe. Common symptoms include:
- Fever
- Chills
- Back pain
- Chest tightness
- Shortness of breath
- Hives
- Itching
- Nausea If any of these symptoms occur during or after a transfusion, it is essential to notify medical staff immediately, as they may need to stop the transfusion and provide treatment. According to the Association of Anaesthetists guidelines, published in 2025 in the journal Anaesthesia 1, a more personalized approach is recommended, which is tailored to the patient’s symptoms and signs to distinguish between febrile and allergic reactions. For febrile reactions, only intravenous paracetamol may be required, whereas for allergic reactions, only an antihistamine should be administered. In cases of severe reactions and/or anaphylaxis, local anaphylaxis protocols should be followed, as outlined in the guidelines 1. It is crucial to note that repeated doses of steroids may further suppress immunity in patients who are immunocompromised, and therefore, steroids and/or antihistamines should not be used indiscriminately 1. By following these guidelines and taking a personalized approach to treating blood transfusion symptoms, healthcare providers can help minimize the risk of adverse reactions and ensure the best possible outcomes for patients.
From the Research
Blood Transfusion Symptoms
- Symptoms of blood transfusion reactions can be overlapping and nonspecific 2
- Acute adverse reactions to transfusion can occur within 24 hours and include:
- Acute hemolytic transfusion reaction
- Febrile nonhemolytic transfusion reaction
- Allergic and anaphylactic reactions
- Transfusion-related acute lung injury
- Transfusion-related infection or sepsis
- Transfusion-associated circulatory overload 3
- Delayed transfusion adverse reactions can develop 48 hours or more after transfusion and include:
- Erythrocyte and platelet alloimmunization
- Delayed hemolytic transfusion reactions
- Posttransfusion purpura
- Transfusion-related immunomodulation
- Transfusion-associated graft versus host disease
- Iron overload with long-term transfusion 3
- Anaphylaxis is a potentially life-threatening, multisystem allergic reaction that can cause airway, breathing, or circulatory compromise, and can occur as a result of blood transfusion 4, 5
- Symptoms of anaphylaxis can include:
- Rapid onset of symptoms
- Cutaneous, respiratory, cardiovascular, and gastrointestinal system involvement
- Death can occur within minutes if left untreated 4
- Treatment of anaphylaxis typically involves the administration of epinephrine, either intramuscularly or intravenously, as well as aggressive fluid resuscitation and supplemental oxygen 4, 5