Name of the Procedure

• Common Name: Red Blood Cells Transfusion
• Medical Term: Red Blood Cells, Leukocytes Reduced, CMV-Negative, Irradiated, Each Unit (P9058)

Summary

This procedure involves the transfusion of red blood cells that are specifically processed to remove white blood cells, be free of cytomegalovirus (CMV), and are irradiated to prevent certain immune reactions. This type of transfusion is often used in patients with weakened immune systems.

Purpose

The primary aim is to increase the red blood cell count in patients who are anemic or have lost blood. This specific type also helps lower the risk of viral infections (like CMV) and immune reactions during the transfusion.

Indications

The procedure is recommended for:

• Patients with severe anemia or significant blood loss.
• Immunocompromised patients (e.g., those undergoing chemotherapy or organ transplant).
• Patients who require CMV-negative blood products.
• Patients who need irradiated blood to prevent graft-versus-host disease.

Preparation

• No fasting typically required.
• Blood type matching tests are done beforehand.
• A complete blood count (CBC) and other relevant lab tests may be performed.
• The patient might need to inform the healthcare team about any medications or allergies.

Procedure Description

1. The patient is comfortably positioned, usually lying down.
2. An intravenous (IV) line is inserted into a vein.
3. The Red Blood Cells, Leukocytes Reduced, CMV-Negative, Irradiated unit is connected to the IV line.
4. The transfusion is started, and vital signs are monitored throughout.
5. The transfusion usually involves a slow drip to prevent complications; the rate may be adjusted based on patient tolerance and medical condition.
6. The procedure continues until the entire unit is transfused.

Duration

Typically, the transfusion takes about 1-4 hours per unit, depending on the patient's condition and the rate of transfusion.

Setting

The procedure is usually performed in a hospital setting, either in a specialized transfusion center or an inpatient unit.

Personnel

• Registered Nurse (RN) for initiation and monitoring.
• Physician for overall supervision and to address any complications.
• Lab Technician for cross-matching and preparing the blood.

Risks and Complications

• Common: Mild allergic reactions, such as itching or a rash.
• Rare: Febrile reactions, bacterial contamination, transfusion-related acute lung injury (TRALI), and iron overload.
• Immediate risk management might involve antihistamines, steroids, or stopping the transfusion.

Benefits

• Immediate improvement in oxygen-carrying capacity of the blood.
• Reduction in symptoms of anemia, such as fatigue and shortness of breath.
• Decreased risk of infections and immune complications due to the specific processing of the blood.

Recovery

• Vital signs are monitored post-transfusion.
• Patients may need to stay for observation for a short period.
• Instructions on activity limitations and signs of adverse reactions to watch for are provided.
• Follow-up appointments might be necessary to assess the effectiveness of the transfusion and overall condition.

Alternatives

• Oral or intravenous iron supplementation for mild anemia.
• Erythropoiesis-stimulating agents (ESAs) to stimulate red blood cell production.
• Hematopoietic stem cell transplantation for certain conditions.
• Each alternative has different pros and cons, based on effectiveness, speed of acting, and patient-specific medical conditions.

Patient Experience

• Some discomfort from needle insertion.
• Potential side effects like mild itching or fever.
• Close monitoring ensures any discomfort or complications are addressed rapidly.
• Pain management and comfort measures, such as blankets or local warming, are available during the procedure.