TY  - CHAP
M1  - Book, Section
TI  - Acute haemolytic transfusion reaction (ABO incompatibility)
A1  - Smith, Graeme
PY  - 2018
T2  - Problem Solving in Haematology
AB  - A  45-year-old  woman  with  severe  menorrhagia  due  to  uterine  fibroids  has  failed  to  respond  to  medical  treatment  and  is  admitted  for  elective  abdominal  hysterectomy.  Her  pre-operative  blood  count  shows  haemoglobin  (Hb)  10.5  g/dl  (reference  range  11.5–16.5)  and  mean  cell  volume  75  fl  (80–98).  On  the  first  post-operative  day  her  Hb  is  9.5  g/dl  but  pulse  rate  and  blood  pressure  are  normal.  Her  surgeon  orders  that  she  be  transfused  with  two  units  of  red  cells.  She  has  never  been  transfused  before.  Ten  minutes  after  starting  the  first  unit  of  red  cells  she  complains  of  pain  at  the  infusion  site,  rapidly  followed  by  the  onset  of  rigors,  vomiting  and  bilateral  loin  pain.  On  examination  she  is  flushed  and  agitated,  and  has  pulse  rate  140  beats/min,  blood  pressure  90/60  mmHg  and  temperature  37.5°C.  Within  minutes  she  becomes  increasingly  shocked  and  confused  and  blood  starts  oozing  from  her  fresh  abdominal  wound.  The  urine  in  her  urinary  catheter  bag  is  noted  to  be  red.What  is  the  most  likely  cause  of  her  acute  deterioration?What  is  the  most  important  differential  diagnosis?How  would  you  manage  and  investigate  the  problem?What  are  the  most  likely  root  causes  of  this  problem  and  what  preventative  measures  can  be  taken?  
SN  - 
PB  - Clinical Publishing Oxford
CY  - New York, NY
Y2  - 2021/03/09
UR  - hemonc.mhmedical.com/content.aspx?aid=1152482283
ER  -