Page 21 - REBRAME - Revista Brasileira de Medicina de Emergência

BRAZILIAN JOURNAL OF EMERGENCY MEDICINE VOLUME 01 / 14-18

INTRODUCTION LTDA. was searched for transfusion requests (TR) recorded
in the period from July 1, 2020 to July 31, 2021. The
According to Article 6 of Consolidation Ordinance No. 5 information extracted was tabulated in Excel spreadsheet,
of November 22, 2017 (Origin: PRT MS/GM 158/2016), consisting of the transfusion modality (1 - scheduled, 2 -
“the transfusion of blood and its components shall be used routine, 3 - urgent, 4 - emergency and 5 - reserve), type
judiciously in medicine, since every transfusion carries in and amount of blood products prescribed (RBC - Red
itself a risk to the recipient, whether immediate or delayed, blood cell, PC - platelet concentrate, APC - apheresis
and must be indicated judiciously.” According to current platelet concentrate, PFC - fresh frozen plasma, CRIO
legislation, there are four types of transfusion, namely: - cryoprecipitate, and CP - convalescent plasma).
scheduled, routine, urgent and emergency . When the delay in The incidence of transfusion reactions and history of
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transfusion could be life-threatening (emergency), the special alloimmunization against red blood cell antigens of the
transfusion protocol is activated and group “O” Negative patients seen during this period were also evaluated.
red cell concentrates can be used without completing the Among the transfusion modalities, we evaluated the profile
pre-transfusion tests, as long as clinically justifiable , with of patients admitted with RC in an emergency basis, based
the prescribing physician being responsible for such an act .
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on the following variables: gender, age, diagnosis and
Although it is allowed, pre-transfusion testing is essential clinical protocol. Data were collected only after the consent
to ensure transfusion safety, especially for patients of the medical director.
alloimmunized against red blood cell antigens other than
the ABO system and RhD antigen, such as Rh, Kell, Kidd, RESULTS
Duffy, MNS, Diego, among others. In emergency situations,
when tests are not performed prior to transfusion, and A total of 21,768 transfusion requests were registered in the
therefore possible clinically significant alloantibodies are established period, which resulted in the prescription of
not identified in a timely manner, the recipient runs the risk 58,218 blood components for 13,823 patients. Among the
of severe, potentially fatal hemolytic reactions . Therefore, requests, 1,476 (6.8%) were programmed, 8,285 (38.1%)
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the objective of this study was to verify the general profile routine, 4,147 (19.1%) urgent, 300 (1.4%) emergency
of transfusion requests, as well as the hemocomponents and 7,560 (34.6%) reservations. The amount of blood
prescribed, evaluating mainly patients that received red components prescribed in each modality is shown in table 1.
blood cells on an emergency basis.
Despite the high number of requests and blood components
METHODS prescribed, only 100 transfusion reactions were recorded,
which alerts us to possible under-reporting. The most
prevalent was the allergic reaction, with 52% of the cases,
The computerized system of FUJISAN - Centro de 34% mild, 14% moderate, and 4% severe. The other
Hemoterapia, Hematologia e Terapia Celular do Ceará
reactions are shown in table 2.

Table 1. Blood products requested by requisition and transfusion modality.
Fresh Frozen Convalescent
Red Blood Cell Platelet Apheresis Platelet Cryoprecipitate
Plasma Plasma
Transfusion N TR Units N TR Units N TR Units N TR Units N TR Units N TR Units
modality prescribed prescribed prescribed prescribed prescribed prescribed
Programmed 954 1371 158 970 137 169 165 619 22 177 40 375
Routine 6018 8147 908 6267 507 569 696 1803 124 925 32 326
Urgent 2752 4269 454 3303 285 292 569 1480 78 583 9 41
Emergency 182 368 36 226 16 17 52 153 14 118 0 0
Reserve 5094 11784 855 6694 90 97 1096 3657 422 3403 3 15
Total 15000 25939 2411 17460 1035 1144 2578 7712 660 5206 84 757
TR: Transfusion Request.

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