From the Research
Premedications such as acetaminophen and diphenhydramine should not be routinely administered before platelet transfusion in patients with a history of transfusion reactions, as the evidence does not support their effectiveness in preventing nonhemolytic transfusion reactions 1. The use of premedications like acetaminophen and diphenhydramine has been a common practice to prevent transfusion reactions, but recent studies have shown that their benefits are not significant.
- A systematic review and meta-analysis published in 2019 found that routine premedication with acetaminophen and antihistamines did not prevent nonhemolytic transfusion reactions 1.
- Another study published in 2002 found that premedication with acetaminophen and diphenhydramine did not significantly lower the incidence of nonhemolytic transfusion reactions compared to placebo 2.
- A literature review published in 2014 also questioned the need for premedication in settings where leukoreduction is used, as the evidence does not support its benefit in minimizing transfusion-related reactions 3. It is essential to document any previous transfusion reactions in the patient's chart and alert the blood bank, as additional precautions such as leukoreduced or washed blood products might be necessary depending on the type of previous reaction.
- The decision to use premedications should be made on a case-by-case basis, taking into account the patient's medical history and the severity of previous reactions.
- Healthcare providers should consider alternative strategies to prevent transfusion reactions, such as the use of leukoreduced blood products, which have been shown to be effective in reducing the incidence of febrile nonhemolytic transfusion reactions 3.