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2 Minute EBP Challenge

Monday, January 30, 2012
Scrub the Hub
The Centers for Disease Control (CDC) recommends that central venous catheter (CVC) hubs be scrubbed for how long?

Monday, January 23, 2012
Severe Sepsis and AF Risk
Up to 20% of patients with severe sepsis develop a new onset atrial fibrillation.  Which factor was not associated with increased risk?

Monday, January 16, 2012
Unreported Hospital Errors
In a recent study the Department of Health and Human Service reports that what percentage of hospital errors go unreported?

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  • Get tips, timesavers, and more from
    David W. Woodruff, MSN, RN-BC, CNS, CMSRN, CEN

    Home > 2 Minute EBP Challenge > Complications of Blood Transfusion

    Complications of Blood Transfusion

    Monday, January 04, 2010

    Stay up-to-date the easy way!

    How would you answer this question?

    As many as 84-90% of patients having surgery develop perioperative anemia.  Perioperative blood transfusion is necessary in many of these patients due to anemia preoperatively or blood loss during surgery.  Which of the following is an adverse effect of perioperative blood transfusion?

    a. Increased mortality
    b. Increased length of stay
    c. Immunosuppression
    d. All of the above

    The correct answer is "d" all of the above.

    Perioperative anemia is a common problem faced by nurses.  The traditional treatment is blood transfusion, and although generally considered safe, blood transfusions can lead to many complications including immunosuppression, increased infections rates, increased mortality and increased length of stay.

    The underlying cause of all of these adverse effects is a systemic inflammatory response.  When banked blood is transfused into the patient an inflammatory response occurs due to antigens on the transfused blood.  Despite typing and crossmatching blood products, the blood belongs to someone else and a minor inflammatory reaction will occur.  Maybe you have witnessed the slight increase in temperature that occurs when transfusing blood.  This is an indication of the underlying inflammation.

    The inflammatory reaction will be magnified by giving additional units of blood products.  So, the chance of adverse effects goes up with each additional unit of blood products that are transfused.

    The systemic inflammatory response syndrome (SIRS) caused by blood transfusion leads to inflammation in other organs, like the lungs (ARDS), and immunosuppression.  The overwhelming inflammation from SIRS consumes immune components leading to immunosuppression. 

    The main thing to remember in relation to transfusions is that your patient will have an inflammatory response to blood products and that significant adverse effects and complications can arise.  Try to limit the amount of blood your patients need by decreasing blood draws using "pediatric" tubes, returning "the waste" to the patient when drawing through a central line, and implementing measures to stop bleeding when it occurs.

    From: Jaffer, A., et al. (2009). Anemia Management Today: Blood Conservation, Transfusion, & New Options.  Retrieved from http://cme.medscape.com/viewprogram/7403 on January 4, 2010. 

    Congratulations to Eileen Negri who won an autographed copy of my 101 Tips to Improve Your Nursing Care book for answering this week's question correctly.  Congratulations Eileen!   

    Best wishes,
    David W. Woodruff, MSN, RN-BC, CNS, CEN
    President,     Ed4Nurses, Inc.

    PS. Ed4StudentNurses.com has resources for students too!

    (c) 2010 Ed4Nurses, Inc.  Feel free to print this e-mail and share it with your colleagues. Other forms of digital or print reproduction are prohibited without prior written consent from Ed4Nurses, Inc.
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