Hemotransfusion shock manifests itself in the first minutes when blood of an incompatible group is introduced into the human body. This condition is characterized by reddening of the face, increased heart rate, shortness of breath, drop in blood pressure, disruption of the cardiovascular system, loss of consciousness, and involuntary discharge of urine and feces.
Causes of post-transfusion shock
Hemotransfusion shock occurs when incompatible blood is transfused, if the group, Rh factor or other isoserological signs have been determined incorrectly. Shock can also be caused by a transfusion of compatible blood if:
- the patient's condition has not been studied enough;
- blood used for transfusion is of poor quality;
- there is an incompatibility between the proteins of the recipient and the donor.
Transfusion shock
In most cases, immediately after medical care, the patient's conditiontemporarily improves, but later there is a picture of serious damage to the kidneys and liver, which sometimes ends in death. Acute kidney dysfunction is accompanied by the appearance of blood in the urine, a further decrease and complete cessation of urination. Signs of intravascular hemolysis and acute renal dysfunction may also be observed.
Depending on the level of pressure of the patient, there are three stages of post-transfusion shock:
- 1st - pressure up to 90 mm Hg. Art.;
- 2nd - up to 70 mm Hg. Art.;
- 3rd - below 70 mmHg st.
The severity of the state of hemotransfusion shock and its consequences directly depend on the disease itself, on the patient's condition, his age, anesthesia and the amount of blood transfused.
Emergency care for transfusion shock
When a patient develops transfusion shock, he needs the following emergency care:
- Administration of sympatholytic, cardiovascular and antihistamines, corticosteroids and inhalation of oxygen.
- Transfusion of polyglucin, blood of a suitable group in a dosage of 250-500 ml or plasma in the same amount. Introduction of a 5% bicarbonate solution or a 11% sodium lactate solution in an amount of 200-250 ml.
- Pararenal bilateral blockade with novocaine according to Vishnevsky A. V. (introduction of novocaine solution 0.25-0.5% in an amount of 60-100 ml).
In most cases, such anti-shock measures lead to an improvement in the conditionsick.
Treatment of transfusion shock
But the main anti-shock measure is exchange blood transfusion as the most effective remedy to prevent kidney damage at an early stage of complications. Exchange transfusion is performed only after a thorough examination of the donor and recipient. For this procedure, only fresh blood is used at a dosage of 1500-2000 ml.
Hemotransfusion shock in the acute stage requires immediate treatment. With the development of anuria with azotemia, the "artificial kidney" apparatus is currently being successfully used, with the help of which the patient's blood is purified from toxic products.
