Abstract Objective To evaluate the effects of both dexamethasone (DXM) and promethazine (PMT) on prevention of the febrile
reactions caused by blood
transfusion. The remaining 474 patients who did not receive DXM and PTM were assigned as controls. Methods Statistical analysis was used. 474 out of 948 patients who were given blood transfusion in our hospital were divided into two groups with prophylactic use of drugs administration for 316 patients in DXM group and 158 patients in PMT group. DXM 5 mg (iv) or PTM 25 mg (im) was given for each group before blood transfusion. The remaining 474 patients who did not receive DXM and PTM were assigned as controls. Results The effective rate of DXM in preventing the pyrexial transfusion reaction was 91.14%, compared with 84.39% of the control group, (P<0.01). The effective rate of PMT in preventing the febrile reaction of blood transfusion reached 78.48%, compared with 84.39% of the control group, (P>0.05). The comparison between the effective rate of DXM group (91.14%) and that of PMT group (78.48%) showed statistical difference (P< 0.001). Discussion and conclusion Up to now, the exact rate of the responses (fever) of blood transfusion is not clear. It was reported in the foreign literature that febrile
reactions of blood transfusion would make up 54% of all the blood transfusion responses, but according to our data, it occurred in 82.16% of the patients. The disagreement might be due to different standards for the responses (fever). In our data, the effective rate (91.14%) for DXM in preventing the febrile reactions in blood transfusion is higher than that of hydrocortisone (86.30%), which has been reported in the literature. This shows that the prophylactic effect of DXM is better than hydrocortisone. DXM 10 mg (administration dose for 2 units of fresh blood) will not produce other side effects such as hemorrhagic tendency. Therefore DXM is much safer even if it is administered to a hemorrhagic patient. DXM produces effects after it is hydrogenated, so it must be administered half an hour or earlier before a blood transfusion. In our opinion, patients with a severe initial disease should be given DXM to prevent the febrile reactions in blood transfusion. Such patients cannot stand attack of febrile reaction. DXM can reduce the febrile reactions of blood transfusion, but the preventive drug (DXM, PMT) cannot lower the degree of the febrile reactions in blood transfusion. Thus, it has nothing to do with the preventive drugs whether or not the febrile reaction in blood transfusion is serious.