From the Research
For pediatric blood transfusion reactions, pheniramine (an antihistamine) is typically dosed at 0.5-1 mg/kg/dose given intravenously, with a maximum single dose of 25-50 mg, as supported by the most recent and highest quality study available 1. This medication should be administered slowly over 5-10 minutes to prevent hypotension. Some key points to consider when managing pediatric blood transfusion reactions include:
- Stopping the transfusion immediately if a reaction is suspected
- Monitoring vital signs and reporting the reaction to the blood bank
- Adjusting the dose based on the child's weight and clinical response
- Monitoring for side effects such as sedation, dry mouth, and urinary retention
- Considering additional interventions for severe reactions, including epinephrine, corticosteroids, oxygen, and supportive care It's also important to note that the incidence of transfusion reactions is higher in pediatric patients compared to adults, with a higher incidence of allergic transfusion reactions, febrile nonhemolytic transfusion reactions, and hypotensive transfusion reactions 2. The best way to prevent transfusion reactions is to avoid unnecessary blood transfusions and maintain a transfusion-restrictive strategy, as well as to be aware of the pathophysiology, initial management, and risks of each type of transfusion reaction 1. Always prioritize the patient's safety and well-being, and consult with a hematologist or other specialist if necessary.