The basic principles in treating transfusion-associated bacterial sepsis include early clinical
suspicion, rigorous implementation of diagnostic procedures, appropriate causal therapy,
inhibiting generalized inflammatory reactions predisposing to complications.
When a fast growing fever appears, the transfusion should be discontinued, the container
with the accompanying drains secured, and a blood sample taken from the patient so that
microbiological tests can be done. The blood sample for culturing should be taken from
another vein than the one into which the blood component has been transfused.
Before microbiological tests findings are available, empiric therapy should be introduced.
Antibiotic therapy should include such broad spectrum antibiotics as ß-lactams and
aminoglycosides. When bacterially contaminated red blood cell concentrate transfusionassociated
sepsis is suspected, an antibiotic with anti-Pseudomonas activity should be
introduced. Then targeted antibiotic therapy should be started. When a septic shock occurs,
shock-controlling procedures should include monitoring hemodynamics, respiratory
efficiency and kidney function. In fluid resuscitation, crystalloids and natural or artificial
colloid solutions are used. The first transfusion consists of 500 – 1000 ml of crystalloids or
300 – 500 ml of colloids during 30 minutes, and is repeated depending on such parameters
as blood pressure, diuresis, and possibly volume overload.