Blood transfusion shock occurs in the first minutes when an incompatible group of blood is introduced into the human body. This condition is characterized by redness of the face, increased heart rate, difficulty breathing, a drop in blood pressure, impaired cardiovascular system, loss of consciousness, and involuntary discharge of urine and feces.
Reasons for the development of post-transfusion shock
Hemotransfusion shock occurs when transfusion of incompatible blood, if the group, Rh factor or other isoserological signs were identified incorrectly. Also, shock can be caused by transfusion of compatible blood in those cases if:
- insufficiently studied condition of the patient;
- blood used for transfusion is poor quality;
- there is an incompatibility of the recipient and donor proteins.
Blood transfusion shock
In most cases, immediately after medical care , the patient’s condition temporarily improves, but later a picture of a serious damage to the kidneys and liver is noted, which sometimes ends in death. Acute renal dysfunction is accompanied by the appearance in the urine of blood, a further decrease and complete cessation of urination. You can also observe the appearance of signs of intravascular hemolysis and acute renal dysfunction.
Three stages of post-transfusion shock are distinguished depending on the patient’s pressure level:
- 1st - pressure up to 90 mm RT. st .;
- 2nd - up to 70 mm Hg. st .;
- 3rd - below 70 mm Hg. Art.
The severity of the state of blood transfusion shock and its consequences directly depend on the disease itself, on the condition of the patient, his age, anesthesia and the amount of blood transfused.
Emergency care for blood transfusion shock
When a patient develops a blood transfusion shock, he needs the following emergency care:
- The introduction of sympatholytic, cardiovascular and antihistamines, corticosteroids and inhalation of oxygen.
- Transfusion of polyglucin, a suitable group of blood at a dosage of 250-500 ml or plasma in the same amount. The introduction of a solution of bicarbonate 5% or a solution of sodium lactate 11% in an amount of 200-250 ml.
- Perinephric bilateral blockade with novocaine according to A. Vishnevsky (introduction of a novocaine solution of 0.25-0.5% in an amount of 60-100 ml).
In most cases, such anti-shock measures lead to an improvement in the patient's condition.
Treatment of blood transfusion shock
But the main anti-shock measure is exchange blood transfusion as the most effective therapeutic agent that can prevent kidney damage at an early stage of complication. Exchange transfusion is carried out only after a thorough examination of the donor and recipient. For this procedure, only fresh blood is used in a dosage of 1500-2000 ml.
Acute blood transfusion shock requires immediate treatment. With the development of anuria with azotemia, the “artificial kidney” apparatus is currently being successfully used, with which the patient’s blood is cleaned of toxic products.