Acetaminophen Premedication for the Prevention of Febrile Non-Hemolytic Transfusion Reaction (FNHTR): An Evidence-Based Case Report

Introduction: A 25 years old woman with severe blood loss (Hb: 5.2 g/dL) caused by menorrhagia was given emergency transfusion with packed red cell (PRC). At the second transfusion patient showed Febrile non-Hemolytic Transfusion Reaction (FNHTR). The physician considered giving premedication for the next transfusion as a prevention. Methodology: In order to assess the clinical effect of giving acetaminophen premedication for the prevention of FNHTR, a structured literature was conducted on PubMed (R), Proquest (R), CochraneLibrary (R), EBSCOHost (R), and ScienceDirect (R). Selection of articles is based on inclusion and exclusion criteria. One systematic review article was selected and critically appraised based on Center of Evidence-based Medicine, University of Oxford criteria. Results: The validity of the systematic review meets the criteria with the heterogeneity of the data. The article showed no significant difference in administrating acetaminophen and diphenhydramine to prevent FNHTR, based on the three research-quality RCTs with low and moderate bias. Conclusion: Based on the highest level of evidence, there was no significant difference giving acetaminophen premedication to prevent FNHTR. However, the general conclusion is still inconclusive. More studies with better methodology were required in order to recommend the therapy in this case.