How are anaphylactic transfusion reactions managed?

Updated: Jan 12, 2021
  • Author: S Gerald Sandler, MD, FCAP, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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In anaphylactic reactions, a subcutaneous injection of epinephrine (0.3-0.5 mL of a 1:1000 aqueous solution) is standard treatment. If the patient is sufficiently hypotensive to raise the question of the efficacy of the subcutaneous route, epinephrine (0.5 mL of a 1:10,000 aqueous solution) may be administered intravenously. Although no documented evidence exists that intravenous corticosteroids are beneficial for the management of acute anaphylactic transfusion reactions, theoretical considerations cause most clinicians to include an infusion of hydrocortisone or prednisolone if an immediate response to epinephrine does not occur.

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