Kritik Hastada Transfüzyon İlkeleri ve Transfüzyon Reaksiyonları

Abstract

Kan ürünlerinin transfüzyonu kritik hastalarda sıklıkla uygulanan işlemlerdendir. Başlıca eritrosit süspansiyonu, trombosit süspansiyonu ve taze donmuş plazma transfüzyonları yapılmaktadır. Hastaların sağkalımına ve iyileşme sürecine olumlu etkileri bulunan bu işlemlerin aynı zamanda yan etkiler oluşturarak, morbiditeyi ve mortaliteyi artırabileceği unutulmamalıdır. Bu nedenle, transfüzyon endikasyonlarının doğru belirlenmesi ve hasta özelliklerine göre hedef belirlenmesi gerekmektedir. Bu doğrultuda yapılmış olan birçok çalışma bulunmaktadır. Bu çalışmalar sonucunda, bazı rehberler oluşturulmuştur. Bu çalışmalar ve bu rehberler aracılığıyla gereksiz transfüzyondan kaçınılması ve transfüzyondan azami fayda sağlanması amaçlanmaktadır. Eritrosit süspansiyonu transfüzyonunda, genel popülasyonda, hedef hemoglobin eşiğini yüksek tutmanın, eşiği düşük tutmaya bir üstünlüğü gösterilmemiştir. Ayrıca, septik hastalar ve kardiyovasküler komorbiditeli hastalarda hedef hemoglobin düzeylerinin bireyselleştirilmesi daha uygun görünmektedir. Trombosit transfüzyonu için hastanın spontan kanama riski veya yapılacak olası işlemler sırasındaki kanama riski göz önünde bulundurularak transfüzyon kararı verilmelidir. Kanama riski düşük olan veya risk olmayan olgularda transfüzyondan kaçınılmalıdır. Taze donmuş plazma transfüzyonu, doğru endikasyonlarda uygulanmalı ve kanama riskine göre yapılmalıdır. Bütün kan ürünleri transfüzyonları sırasında ve sonrasında transfüzyon reaksiyonları gelişebileceği bilinmeli; bunlara karşı uygun önlemler alınmalı ve gerektiğinde uygun tedavi başlanmalıdır

Keywords

• Kan Transfüzyonu
• Transfüzyon Reaksiyonu
• Kritik Hastalık
• Eritrosit Transfüzyonu
• Platelet Transfüzyonu
• Kan Ürünü Transfüzyonu

Kritik Hastada Transfüzyon İlkeleri ve Transfüzyon Reaksiyonları

Abstract

Blood product transfusions are frequently performed during critical illnesses. Primarily; erythrocyte suspension, platelet suspension and fresh frozen plasma transfusions are performed. It should not be forgotten that these procedures, which have positive effects on the survival and healing process of patients, may also cause side effects and increase morbidity and mortality. Therefore, it is necessary to determine the indications of transfusions correctly and determine the goals according to the patient characteristics. There are many studies done in this regard. In light of these studies, several guidelines have been prepared. Through these studies and these guidelines, avoidance of unnecessary transfusions and optimum benefit in transfusions are aimed. Regarding transfusion of erythrocyte suspensions in the general population, higher target hemoglobin levels have not been shown to be superior to lower target levels. In addition, target hemoglobin levels should be individualized in septic patients and the patients with cardiovascular comorbidities. While giving platelet transfusion, the transfusion decision should be made considering the risk of spontaneous bleeding and the risk of bleeding during possible interventions. The transfusion should be avoided in cases of low bleeding risks or non-risk events. Fresh frozen plasma transfusions should be performed with correct indications and the bleeding risk should be taken into account. During and after transfusion of all blood products transfusion reactions may develop; appropriate precautions should be taken and prompt treatment should be given as needed.

Keywords

• Blood Transfusion
• Transfusion Reaction
• Critical Illness
• Erythrocyte Transfusion
• Platelet Transfusion
• Blood Omponent Transfusion

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