From the Guidelines
Hypothermia following blood transfusion is primarily caused by the infusion of cold blood products, which can lower the patient's core body temperature, and can be prevented by warming blood products to approximately 37°C (98.6°F) using an approved blood warming device before administration, as recommended by the most recent guidelines 1. The causes of hypothermia following blood transfusion can be attributed to several factors, including:
- Infusion of cold blood products, such as red blood cells, which are stored at cold temperatures (2-6°C) to preserve their viability 1
- Rapid transfusion of large volumes of blood products, which can overwhelm the body's temperature regulation mechanisms 1
- Vulnerable patient populations, such as children, elderly, trauma victims, or those undergoing lengthy procedures, who are more susceptible to hypothermia 1 To prevent and manage transfusion-associated hypothermia, the following measures can be taken:
- Warming blood products to approximately 37°C (98.6°F) using an approved blood warming device before administration 1
- Using forced air warming or underbody warming mattresses to maintain normothermia 1
- Administering intravenous fluids and blood products using fluid warmers 1
- Monitoring core temperature closely and taking prompt action if hypothermia develops 1 It is essential to note that hypothermia can have severe consequences, including cardiac arrhythmias, coagulopathy, and increased oxygen consumption during rewarming, and therefore, proactive warming of blood products is crucial in high-risk patients or massive transfusions 1.
From the Research
Causes of Hypothermia Following Blood Transfusion
- Hypothermia can occur due to the transfusion of cold blood products, which can lead to a drop in the patient's core temperature 2, 3, 4
- The use of rapid transfusion methods can also contribute to hypothermia, as large amounts of cold blood are introduced into the patient's body in a short amount of time 2, 4
- Failure to use blood warmers or other warming devices during transfusion can increase the risk of hypothermia 2, 5, 4
- The type of blood warmer used and its effectiveness in warming the blood to a safe temperature can also impact the risk of hypothermia 5, 4
- Patient factors, such as the severity of injury or illness, can also contribute to the development of hypothermia during blood transfusion 3, 6
Risk Factors for Hypothermia
- Massive transfusion, defined as the transfusion of large amounts of blood in a short period of time, increases the risk of hypothermia 2, 3, 4
- The use of cold blood products, such as those stored at refrigerated temperatures, can increase the risk of hypothermia 2, 5
- The presence of underlying medical conditions, such as coagulopathy or acidosis, can increase the risk of hypothermia and its complications 3, 6
- The failure to monitor and maintain normothermia during transfusion can increase the risk of hypothermia and its complications 2, 5, 4, 6
Consequences of Hypothermia
- Hypothermia can lead to coagulopathy, which can increase the risk of bleeding and transfusion requirements 3, 6
- Hypothermia can also lead to increased blood loss and transfusion requirements, even in the absence of coagulopathy 6
- Severe hypothermia can increase the risk of mortality, particularly in patients with severe injuries or underlying medical conditions 3