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Blood Transfusion

Acute Opioid Withdrawal Precipitated by Blood Transfusion in a 21-Year-Old Male

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To the Editor:

Cancer patients can be among the most challenging groups in which to maintain pain control. At our institution, many cancer patients are managed with patient-controlled analgesia (PCA) opioids, sometimes on an outpatient basis. These patients frequently undergo multiple surgeries as well as courses of chemotherapy and radiotherapy and, as a result, often require multiple blood product transfusions. According to the American Association of Blood Banks standard,1 blood transfusions should not be co-administered with any intravenous drugs or fluids apart from 0.9% sodium chloride. For many cancer patients, it is difficult or impractical to establish additional intravenous access solely for blood product administration, and therefore, the practice at our institution has been to disconnect any current intravenous infusion for the duration of blood product transfusion. Here, we describe a case of severe opioid withdrawal after disconnection of intravenous hydromorphone PCA and initiation of a blood transfusion....

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Acute Lung Injury Following Blood Transfusion: Expanding the Definition

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Abstract and Introduction

Abstract

Objective: Acute lung injury (ALI) is a well known complication following the transfusion of blood products and is commonly referred to as transfusion-related acute lung injury (TRALI). The objectives of this review are to summarize current knowledge of TRALI with an emphasis on issues pertinent to the intensivist and to define the newly recognized Delayed TRALI syndrome.

Data synthesis: The classic TRALI syndrome is an uncommon condition characterized by the abrupt onset of respiratory failure within hours of the transfusion of a blood product. It is usually caused by anti-leukocyte antibodies, resolves rapidly, and has a low mortality. A single unit of packed cells or blood component product is usually implicated in initiating this syndrome. It has, however, recently been recognized that the transfusion of blood products in critically ill or injured patients increases the risk (odds ratio 2.13; 95% confidence interval 1.75-2.52)...

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Medicolegal Assessment Of Blood Transfusion Errors–an Interdisciplinary Challenge.

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Abstract

Given a current total incidence of erroneously administered blood transfusions of 1:12,000-1:36,000 (AB0 incompatible 1:38,000), the percentage of lethal outcomes ranges between 2 and 5%; i.e. the sole fact of an erroneous transfusion does not mandatorily result in a causal connection with lethal outcome, which can give rise to problems in the medicolegal assessment. We report on the conception and results of a novel interdisciplinary approach to assess the lethal significance of blood transfusion errors. Besides autopsy, histological investigation and immunohistochemical detection of AB0 incompatible foreign red blood cells in autopsy specimens, transfusion medicine investigations offer the opportunity to assess several immunohaematologic features. We assessed the immunohaematologic gel card ("microcolumn") technique for suitability in the forensic assessment of an AB0 incompatible transfusion incident in a septic patient, who had had no history of previous blood transfusions, with lethal outcome. After such an erroneous transfusion had been simulated in vitro, pre-transfusion...

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A History On The Use Of Blood Transfusions In Cycling

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The recent revelations by the Dutch newspaper De Volksrant concerning the PDM team's doping regime at the 1988 Tour de France raise more questions than they answer, particularly with regard to the use of blood transfusions in 1980s cycling. Here we consider what is known about the use of transfusions in general and some of the questions these latest PDM revelations raise in relation to the history of blood doping in cycling.

Part I

What is known about the use of blood transfusions in sport, particularly in cycling? Most people will be able to tell you that the Finnish middle-distance runner Lasse Virén is said to have made use of transfusions when winning at the Munich and Montreal Olympics in 1972 and 1976. Most people will also be able to tell you that Francesco Moser broke Eddy Merckx's Hour Record in 1984 with the help of blood transfusions....

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