What is the appropriate initial management for a febrile non-hemolytic transfusion reaction?

What is the appropriate initial management for a febrile non-hemolytic transfusion reaction?

• A. Continue the transfusion at the same rate and observe.
• B. Administer broad-spectrum antibiotics and proceed.
• C. Stop the transfusion, give antipyretics, recheck crossmatch, resume at a slower rate if stable.
• D. Switch to a platelet transfusion.

Answer: (C)

Febrile nonhemolytic transfusion reactions are usually caused by donor white cells or their cytokines triggering a fever in the recipient. The main priority is patient safety: stop the transfusion immediately to assess for a more serious reaction such as acute hemolysis or sepsis. Once the transfusion is paused, treat the fever with an antipyretic like acetaminophen to help comfort and stabilize the patient. Recheck the product and patient information, and consider retyping/recrossmatching before attempting to restart the transfusion. If the patient remains stable and the fever resolves, you can resume the transfusion at a slower rate with close monitoring, and plan for using leukoreduced components in the future to reduce the risk of recurrence. Antibiotics are not routinely given for FNHTR unless there are signs of infection, and switching to a platelet transfusion isn’t part of the initial management for this reaction.

Febrile nonhemolytic transfusion reactions are usually caused by donor white cells or their cytokines triggering a fever in the recipient. The main priority is patient safety: stop the transfusion immediately to assess for a more serious reaction such as acute hemolysis or sepsis. Once the transfusion is paused, treat the fever with an antipyretic like acetaminophen to help comfort and stabilize the patient. Recheck the product and patient information, and consider retyping/recrossmatching before attempting to restart the transfusion. If the patient remains stable and the fever resolves, you can resume the transfusion at a slower rate with close monitoring, and plan for using leukoreduced components in the future to reduce the risk of recurrence. Antibiotics are not routinely given for FNHTR unless there are signs of infection, and switching to a platelet transfusion isn’t part of the initial management for this reaction.