Hemovigilância das reações adversas imediatas e tardias à doação de sangue no Hemocentro do estado do Amazonas

Abstract

Hemovigilance encompasses surveillance procedures throughout the transfusion chain, with the objective of collecting and evaluating information on adverse effects resulting from the use of blood products, aiming at preventing their occurrence. In Brazil, research on adverse effects in transfusions focuses mainly on the patient. In 2015, the Conceptual and Operational Framework for Hemovigilance was published, which includes specific chapters on blood donors, classifying reactions according to time of occurrence, severity, relationship with donation and type of donation. Objective: To characterize the aspects of hemovigilance associated with immediate and late adverse reactions to blood donation at the Blood Center of the State of Amazonas. Methodology: This is a longitudinal, descriptive and exploratory study, based on documentary analysis of the virtual medical records of the Triage and Collection Management of the Hospital Foundation of Hematology and Hemotherapy of Amazonas (FHEMOAM). The analysis period ran from January 2020 to December 2022, and data were collected from donors of both sexes, aged between 16 and 69 years. The variables investigated include sex, age, type of donor (first donation or return donor), blood typing, Rh factor, nationality, area of residence, clinical screening (internal or external), type of adverse reaction, severity of adverse reactions and time of occurrence, the tool used was descriptive statistics, and the Confidence Interval was calculated for proportions with a 95% confidence level. Results: In this study, 627 records of immediate and late reactions to blood donation were analyzed. The analysis of the data collected between 2020 and 2022 demonstrated an increasing trend in the rates of adverse reactions, with a higher prevalence among female donors and in the age group of 16-25. Blood donors domiciled in the east zone of Manaus presented more adverse reactions, and regarding nationality, it is important to highlight where more and 90% of these donors are from the State of Amazonas. It is possible to verify through the data obtained that primary and sporadic donors presented the highest rates of adverse reactions. It was observed that the adverse reaction rate increases over the three years observed. With a 95% confidence interval, the 2020 rate varies between 0.22% and 0.30%. From 2021, the range increased in the lower and upper range went to 0.29% to 0.39%. In 2022, there were more shifts in the intervals, rising to 0.38% to 0.48%. As shown, blood typing and Rh O+ factor represent the sphere of blood donors with the highest rates of adverse reactions. The predominance of reactions was observed in grade 1, characterized as the mildest, the predominance of the reactions observed was of a single type, which were classified as systemic. The main reactions reported included hypotension, dizziness, nausea, and anxiety. According to the data from the three-year period, nursing care for an adverse reaction during blood donation included the use of the Trendelenburg position. In the three years studied, more than 60% of donors did not return for a new donation, demonstrating low adherence. Conclusion: With the research data, it was possible to characterize the aspects of hemovigilance associated with immediate and late adverse reactions to blood donation at the Blood Center of the State of Amazonas, revealing important insights for improving donation processes and donor assistance. Thus, it is expected that this study will serve as a support tool for managers and health professionals in formulating policies and practices that ensure excellence in blood donor care, with positive impacts on public health and community well-being