General supportive therapy typically leads to recovery without long-lasting sequelae. Air embolism is largely a complication of pressure infusion of blood but it can also happen when an IV set is changed or a plastic blood bag is erroneously vented. Treatment involves turning the patient on the left side, head down, to allow the air to escape a little at a time from the right atrium. Patients with liver failure may have altered ability to metabolize citrate. However, even small numbers of viable lymphocytes in blood or blood component transfusions can divide spontaneously and cause GVHD in immunosuppressed recipients.
Prevention is by irradiation of all blood products intended for transfusion to such patients.
Preventive irradiation is therefore required if donor blood is obtained from a first-degree relative. It is also required when transfusing HLA-matched components, excluding stem cells. In circumstances not complicated by prolonged hypotension or DIC, dilutional thrombocytopenia is the most likely complication. Stored blood does not contain fully functional platelets. Six to eight platelet concentrates are usually enough to correct such bleeding in an adult.