Transfusion Reactions and Fatalities due to Circulatory Overloading

Symptomless Incompatible Transfusion

“…Mollison (1943) mentioned that reactions to incompatible transfusion seemed to be less severe than formerly, and, that this might be due to the fact that transfusions are now commonly given at a drip rate. The danger of transfusing compatible blood rapidly into chronically anaemic recipients has been previously referred to by me (Drummond, 1943) and by others. If the blood is incompatible the effects are almost certain to be aggravated.…”

Rapid Intravenous Transfusions in Children

“…The signs of an overloaded circulation are an elevated jugular venous pressure (Lewis, 1937) and basal rales (Drummond, 1943). DeBakey (1938), in over 5,000 transfusions, never once observed the so-called phenomenon of speed shock (Hyman and Hirshfeld, 1931), and not infrequently 650 ml.…”

“…Sharpey-Schafer and Wallace (1942b) found increased cardiac diastolic size and electrocardiographic changes after transfusions in normal patients. In fatal cases necropsy has shown pulmonary oedema and cardiac dilatation (Plummer, 1936: Fishberg, 1937Drummond, 1943). According to Riddell (1939) the commonest cause of fatality following blood transfusion is circulatory failure secondary to overloading.…”

Circulatory haemodynamics after blood transfusion in chronic severe anaemia.

“…Several investigators (Drummond, 1943;Sharpey-Schafer, 1945;Fullerton and Turner, 1962;Graettinger, Parsons, and Campbell, 1963) have, however, reported heart failure, pulmonary oedema, and deaths in patients with severe anaemia after transfusion of whole blood as well as of packed red cells, either given rapidly or slowly. It is believed that in anaemic patients the functional capacity of the myocardium may be severely impaired and its reserve powers negligible so that any overloading of circulation may then precipitate heart failure (Drummond, 1943). Dangers of circulatory overloading have therefore been stressed and suggestions have been made regarding the amount and the speed of blood transfusion in anaemic patients (Drummond, 1943;Wintrobe, 1961;Britton, 1963).…”