If a patient with severe chronic anemia receives a transfusion of whole blood, which acute transfusion complication is most likely to occur?

In the scenario of a patient with severe chronic anemia receiving a transfusion of whole blood, the most likely acute transfusion complication to occur is fluid overload. This condition arises because transfusion of whole blood can significantly increase the volume of blood and plasma in a patient who may already be experiencing volume overload due to their chronic anemia or other underlying conditions.

Patients with chronic anemia may have compromised cardiovascular function, and adding a large volume of whole blood can lead to heart strain. As the blood volume increases, the risk of fluid overload becomes pronounced, especially if the transfusion is administered rapidly or if the patient has pre-existing heart or kidney issues that impair fluid handling.

Transfusion-associated lung injury, hemolytic reactions, and sepsis are indeed potential complications of blood transfusions, but they are less likely in this specific context. Transfusion-associated lung injury is mainly associated with reactions to antibodies in the donor plasma, which tend to garner attention with specific populations or conditions. Hemolytic reactions are typically related to incompatible blood types rather than total volume issues. Sepsis is a serious risk in transfusions, especially when blood products have not been properly screened, but it is generally a less immediate concern compared to the risk of fluid overload, especially in a patient who