Emergency incompatible red cell transfusion to a patient whose blood type was suspended from identification

Risa Takeuchi, Yasuko Ichihara, Hiroshi Hoshijima, Nobuyuki Matsumoto, Hirosato Kikuchi, Chiaki Satoh, Rumiko Asada, Kenji Ikebuchi

Research output: Contribution to journalArticlepeer-review

Abstract

We report a case of a 59-year-old woman who presented with hypovolemic shock and compensated acidosis (preoperative arterial blood gases : pH 7.3, PCO2 31.9 mmHg, PaO2 112.3 mmHg, base excess -9.8, Hb 6.4 g·dl-1) due to perforated descending colon, necessitating emergency surgery. Tracheal intubation had been performed preoperatively. Prior to induction of anesthesia, blood pressure was 106/74 mmHg, heart rate 119 beats·min-1, and SpO2100% breathing room air. Anesthesia was induced with remifentanil influsion at a rate of 0.05 mg·kg-1·min-1, sevoflurane 1% and rocuronium bromide 30 mg, and was maintained with oxygen, air, remifentanil and sevoflurane. For a critical hypovolemia, in accordance to the guidelines for intraoperative critical hemorrhage and the Japanese practical guidelines for blood components therapy, we started to transfuse incompatible red cell (O +) since the identification of blood typing was suspended. The duration of surgery was 104 min, with an intraoperative total bleeding of 125 ml. Four units of total blood transfusion and 3,050 ml of infusion of Ringer's acetate solution were administered. The patient was transferred to ICU with tracheal intubation. No adverse reactions associated with blood type incompatibility were recognized.

Original languageEnglish
Pages (from-to)602-604
Number of pages3
JournalJapanese Journal of Anesthesiology
Volume61
Issue number6
Publication statusPublished - 2012 Jun 10
Externally publishedYes

Keywords

  • ABO-incompatible red cell transfusion
  • Guideline for intraoperative critical hemorrhage
  • Japanese practical guidelines for the blood component therapy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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