Hemotransfusion citrate shock occurs during the transfusion of incompatible blood. It develops at the beginning or at the end of blood transfusion. In the process of transfusion, donor red blood cells in the vessels are destroyed under the influence of antibodies. In this case, hemoglobin, biogenic amines, potassium and tissue thromboplastin are released. Due to the significant concentration of these elements, a malfunction in the blood vessels occurs and spasms occur. They begin to expand rapidly. For this reason, a lack of oxygen develops, blood circulation is disturbed and the permeability of the walls of the vessels increases. The work of the whole organism is disrupted.
Due to the low oxygen content and necessary metabolites, the kidneys are disturbed during the breakdown of hemoglobin. Hematine hydrochloride is deposited in the tubules of the kidneys. The body ceases to fully perform its basic functions and does not filter the blood. Hemotransfusion citrate shock is characterized by thrombohemorrhagic syndrome.
The main causes
There are a number of reasons for which hemolytic shock can occur. These include:
- medical error in the process of conducting a serological test;
- determination of blood type and Rhesus affiliation - their incompatibility;
- improper storage of donated blood and its poor quality;
- the presence of harmful microorganisms in it.
When a shock occurs in a person, the general state of health significantly worsens. Signs appear as:
- growing anxiety;
- severe overexcitation of the nervous system;
- acute pain, which is localized in the chest and stomach;
- having trouble breathing;
- the skin takes on a blue tint.
With hemolytic citrate shock, a pathological manifestation occurs in the form of severe soreness in the lumbar region. In this case, a circulatory disorder occurs. The functioning of the cardiovascular system is disrupted. Besides:
- there is soreness in the heart;
- the patient is thrown into a fever, then into a cold;
- urine takes on a brownish tint.
Problems associated with blood coagulation develop. This manifests itself in the form of heavy bleeding. Secondary symptoms include:
- increased body temperature;
- numbness of the limbs;
- fecal incontinence.
If the procedure is performed under general anesthesia, then symptoms may be absent. To eliminate the complications of shock, you must be under the supervision of your doctor.
Features of the pathological condition
General well-being in post-transfusion shock directly depends on the volume of blood transfusion. If a person has a shock, first of all, a specialist measures blood pressure and determines the severity of the condition. For example:
- The initial degree is characterized by a pressure level above 92 mm. R. Art.
- In the second degree, blood pressure ranges from 65 to 89 mm. R. Art.
- In the last stage of shock, the pressure drops below 69 mm. R. Art.
At the final stage of the course of citrate shock, the symptoms may change, so the process is difficult to control.
Doctor's view of the problem
With the development of complications, the pressure decreases significantly and the outflow of urine is difficult. There are problems with the functioning of the kidneys. If one of the symptoms of shock appears, it is important to consult a doctor immediately. Thanks to timely treatment, you can protect yourself from complications. Patient treatment takes place in a hospital under the strict supervision of doctors. Over time, overall health is restored. The main causes of citrate shock are neglect of blood storage and improper procedure.
First aid
In the event that hemolytic shock has occurred, it is necessary to provide medical assistance to the patient in a timely manner, namely:
- Suspend a blood transfusion.
- In the event that the patient has complaints and the general condition worsens, a new catheter should be installed.
- Replace transfusion system.
- Monitor the volume of urine that is excreted.
- Provide humidified oxygen.
- Urgently call a laboratory assistant and take a blood test for hemoglobin and red blood cells.
In addition, it is necessary to measure arterial and venous pressure. The treatment of citrate shock should be monitored by a specialist. If there is no reagent, blood incompatibility can be determined using a Baxter test.
Therapies
There are several ways to treat hemolytic shock. These include the following types:
- Infusion therapy. In order to stabilize blood circulation and restore microcirculation, Reopoliglukin and gelatin preparations are poured.
- During treatment, it is important to provoke an alkaline reaction in the urine, which prevents the formation of hemin.
- Specialists use drugs in the form of first aid.
- To get the patient out of shock, they use the classic Prednisolone and Lasix drugs.
- It is important to use an antiallergic medication and narcotic analgesic.
- With the extracorporeal method, toxins and other products that disrupt the functioning of the body are removed from the patient's body.
- With the help of medicines, they correct the functions of other organs.
- Restore the functioning of the kidneys with the help of potent drugs in the event that a citrate shock has occurred. The emergency care provided by the medical worker on time is the key to the patient’s quick recovery.
The treatment method is determined strictly by the doctor. The individual characteristics of each patient in the course of therapy are taken into account.
Preventive methods: the doctor recommends
Prevention of citrate shock includes several expert recommendations. Namely:
- For the purpose of prevention, it is important to strictly observe the rules of blood transfusion and store it correctly.
- It is important to carefully examine the donor and conduct the tests correctly.
- If symptoms of shock appear, it is important to immediately inform the specialist about all the unpleasant sensations that cause discomfort to the patient.
Self-medication is prohibited, as this will lead to death. It is undesirable to transfuse blood in dubious medical facilities.