In aplastic anemia, transfusing red blood cells in small volumes over several hours can help prevent complications; giving units too rapidly can lead to which complication?

In aplastic anemia, transfusing red blood cells in small volumes over several hours can help prevent complications; giving units too rapidly can lead to which complication?

• A. Hyperkalemia
• B. Heart failure
• C. Hypertension
• D. Seizures

Answer: (B)

The main concept here is that the rate of blood transfusion affects the risk of volume overload. When red blood cells are given too rapidly, the sudden rise in intravascular volume can overwhelm the heart’s ability to handle the increased preload, leading to congestive heart failure and pulmonary edema. In aplastic anemia, patients are often chronically anemic with limited cardiac reserve, so a rapid transfusion can precipitate heart failure much more readily than a slow, small-volume infusion. Hyperkalemia from stored blood and other issues can occur in certain transfusion contexts, but the question’s scenario emphasizes the hemodynamic strain from rapid volume increase, making heart failure the most likely complication.

The main concept here is that the rate of blood transfusion affects the risk of volume overload. When red blood cells are given too rapidly, the sudden rise in intravascular volume can overwhelm the heart’s ability to handle the increased preload, leading to congestive heart failure and pulmonary edema. In aplastic anemia, patients are often chronically anemic with limited cardiac reserve, so a rapid transfusion can precipitate heart failure much more readily than a slow, small-volume infusion.

Hyperkalemia from stored blood and other issues can occur in certain transfusion contexts, but the question’s scenario emphasizes the hemodynamic strain from rapid volume increase, making heart failure the most likely complication.