Abstract
Febrile nonhemolytic and allergic reactions are the most common transfusion reactions, but usually do not cause significant morbidity. In an attempt to prevent these reactions, US physicians prescribe acetaminophen or diphenhydramine premedication before more than 50% of blood component transfusions. Acetaminophen and diphenhydramine are effective therapies for fever and allergy, respectively, so their use in transfusion has some biologic rationale. However, these medications also have potential toxicity, particularly in ill patients, and in the studies performed to date, they have failed to prevent transfusion reactions. Whether the benefits of routine prophylaxis with acetaminophen and diphenhydramine outweigh their risks and cost requires reexamination, particularly in light of the low reaction rates reported at many institutions even when premedication is not prescribed.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Acetaminophen / adverse effects
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Acetaminophen / economics
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Acetaminophen / therapeutic use*
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Analgesics, Non-Narcotic / adverse effects
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Analgesics, Non-Narcotic / economics
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Analgesics, Non-Narcotic / therapeutic use*
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Anti-Allergic Agents / adverse effects
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Anti-Allergic Agents / therapeutic use*
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Blood Component Transfusion / adverse effects*
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Blood Component Transfusion / economics
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Blood Component Transfusion / mortality
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Diphenhydramine / adverse effects
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Diphenhydramine / economics
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Diphenhydramine / therapeutic use*
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Fever / economics
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Fever / etiology
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Fever / mortality
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Fever / prevention & control
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Humans
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Hypersensitivity / economics
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Hypersensitivity / etiology
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Hypersensitivity / mortality
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Hypersensitivity / prevention & control*
Substances
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Analgesics, Non-Narcotic
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Anti-Allergic Agents
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Acetaminophen
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Diphenhydramine