Diferencia entre revisiones de «Intravascular hemolytic tranfusion reaction»
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==Evaluation== | ==Evaluation== | ||
*Labs consistent with hemolysis | *Labs consistent with hemolysis | ||
*Send off coombs test/direct antiglobin test | |||
**Coomb's reagent binds RBCs with Ab on them | |||
[[File:Coombs.png|thumbnail]] | |||
==Management== | ==Management== | ||
Revisión del 21:42 26 nov 2016
Background
- Occurs due to ABO incompatibility
- High mortality. 1:30 may die.
Clinical Features
- High grade fever, back/flank pain, headache, hypotension, dyspnea, pulmonary edema, bleeding, renal failure, hematuria
- Sick and shocky
Differential Diagnosis
Transfusion Reaction Types
- Acute
- Delayed
Acute allergic reaction
- Allergic reaction/urticaria
- Anaphylaxis
- Angioedema
- Anxiety attack
- Asthma exacerbation
- Carcinoid syndrome
- Cold urticaria
- Contrast induced allergic reaction
- Scombroid
- Shock
- Transfusion reaction
Evaluation
- Labs consistent with hemolysis
- Send off coombs test/direct antiglobin test
- Coomb's reagent binds RBCs with Ab on them
Management
- Stop transfusion
- Replace all tubing
- Risk of death is proportional to amount of incompatible blood received
- Maintain urine output with IVF (1-2 mL/kg/hr), mannitol, and furosemide as needed
- Treat shock with volume and vasopressors
- Treat coagulopathy with FFP