Intravascular hemolytic tranfusion reaction

Differential Diagnosis

Transfusion Reaction Types

• Acute
  • Intravascular hemolytic tranfusion reaction
  • Febrile nonhemolytic tranfusion reaction
  • Allergic tranfusion reaction
  • Transfusion-associated circulatory overload (TACO)
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated graft-versus-host disease
  • Fluid overload
  • Sepsis
• Delayed
  • Extravascular hemolytic tranfusion reaction
  • Graft-vs-host disease
  • Transfusion infections

See Also

• Transfusion reaction

References

Intravascular Hemolytic Tranfusion Reaction

• Occurs due to ABO incompatibility
• Diagnosis
  • Back pain, headache, hypotension, dyspnea, pulmonary edema, bleeding, renal failure
  • Labs c/w hemolysis
• Treatment
  • 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 w/ FFP