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Administration of Deferoxamine concurrently with PRBC transfusion

  • 1.  Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 26 days ago
    Hello,  I am wondering about infusion policies and procedure regarding infusion of the iron chelating agent, Deferoxamine (Desferal).  Specifically, is it administered through the same IV access concurrently with transfusion of PRBCs?   If anyone has current evidence about this practice and resource referrals, or can tell me about what you do at your facility I will appreciate hearing.  We are evaluating the policy based on the manufacturers insert.  Thank you!

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    Julie Russell RN
    Camarillo CA
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  • 2.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 25 days ago
    We transfused the blood first, Then give deferoxime after I. The same line after the flush is completed.

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    Karin Wolf RN BSN
    San Carlos CA
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  • 3.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 18 days ago
    ​In the way distant past (20 - 30  years ago) it was not uncommon to administer the desferal in the unit of blood as patients didn't have the POC's  / CVAD's and the desferal was done SC infusion; so it was supposed to save another invasive procedure by administering desferal with the blood in a population that had some compliance issues (teenager / young adults). With more stringent blood product / infusion policies this is no longer the practice. There was also an old theory that giving the deferral with the blood may decrease the iron absorption issues and decrease the iron overload (not true). As mentioned by other responders; blood products run on their own line; though we have run concurrent medications on a separate lumen; being VERY SELECTIVE as mentioned for reactivity to the infusions and which infusion may be the cause. Sorry if a history lesson. ron

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    Ron Middleton, CNC
    Haematology Care Coordinator
    Toowoomba Hospital
    Toowoomba, Queensland, Australia
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  • 4.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 14 days ago
    I work in an OUTPATIENT Clinic within the hospital system and we give blood products almost everyday. We currently are seeing two patients who require desferal along with their blood transfusion. One has CHF, the other does not. They both receive 1 gram with each transfusion and infuse it almost the length of time it takes to receive two units of PRBC'S. How long do you guys run the desferal? I have been told that you can infuse it over an hour, prior to or after the blood is given. But,  I  read that 4 hours is preferable.

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    Carol Carter
    RN
    Flowery Branch GA
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  • 5.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 13 days ago
    ​The local infusion information states an maximum IV infusion of 15mg/kg/hour. Also states to reduce the rate when there is clinical improvement. With the newer oral agents, long time since I have done IV or SC infusion.  Thanks Ron

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    Ron Middleton, CNC
    Haematology Care Coordinator
    Toowoomba Hospital
    Toowoomba, Queensland, Australia
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  • 6.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 12 days ago
    Thank you, Ron, for your response. That information is very helpful.

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    Carol Carter
    RN
    Flowery Branch GA
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  • 7.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 12 days ago
      |   view attached
    ​Hi Carol, have attached the reference. Ron

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    Ron Middleton, CNC
    Haematology Care Coordinator
    Toowoomba Hospital
    Toowoomba, Queensland, Australia
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    Attachment(s)

    pdf
    Desferral Info.pdf   383K 1 version


  • 8.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 21 days ago
    ​Most institutions have protocols or policy and procedures that prohibit addition of drugs with blood products.  I have never given anything concurrent with a blood transfusion.  If needed another IV would need to be started.  We have patients that come on separated days for Deferoxamine  (Desferal) and Blood transfusions.  If given on same day we give blood transfusions first flush line then give Desferal.

    Hope this helps.

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    Michele Joseph
    Clifton NJ
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  • 9.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 20 days ago

    We do not administer anything else with blood products – if there is a reaction it would be hard to determine which product caused it. Plus you have to look at the fluid overload – many of our older patients are already at a TACO risk.

     

    Ann Proctor MSN,RN,OCN

    Manager Oncology Clinical Services

    WellSpan Oncology Service Line

    Phone: 717-851-7195

    Fax: 717-741-8638

    E-mail: aproctor@wellspan.org

     

     


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  • 10.  RE: Administration of Deferoxamine concurrently with PRBC transfusion

    Posted 20 days ago
    Thank you for all the helpful input about this topic!   It is good to take into consideration what other institutional guidelines and practices are in place.   Changes are being made where I work which affect our patients so I appreciate this Community Forum to ask and learn!

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    Julie Russell RN

    Camarillo CA
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