View source for Intravascular hemolytic transfusion reaction

==Background==
*Occurs due to ABO incompatibility
*High mortality. 1:30 may die.

==Clinical Features==
*High grade [[fever]], [[back pain|back]]/[[flank pain]], [[headache]], [[hypotension]], [[dyspnea]], [[pulmonary edema]], [[coagulopathy|bleeding]], [[renal failure]], [[hematuria]]
*Sick and [[shock]]y

==Differential Diagnosis==
{{Transfusion reaction types}}

{{Acute Allergic DDX}}

==Evaluation==
*Labs consistent with [[hemolytic anemia|hemolysis]]
*Send off coombs test/direct antiglobin test
**Coomb's reagent binds RBCs with Ab on them
[[File:Coombs.png|thumbnail]]

==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]]
*Consider IV [[methylprednisolone]]

==Disposition==
*Admission
**Most frequently to ICU

==See Also==
*[[Transfusion reaction]]

==External Links==

==References==
<references/>

[[Category:Heme/Onc]]