Emergency Rh- incompatible blood transfusion for severe anemic patient caused by hemorrhagic shock

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  • 外傷性出血性ショックに伴う高度貧血に対して<br>緊急的にRh不適合輸血を施行した1例

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 The case reported here was a male in his thirties who had a history of depression and who had stabbed himself in both sides of the neck with a kitchen knife. He presented with a consciousness level of 20/JCS, blood pressure of 60/33 mmHg, heart rate of 140 beats/minute and hemorrhagic shock. Wounds to the internal jugular vein and carotid artery were found and bleeding was stopped. Since the patient's blood type was determined to be B(-), an order was placed for B(-) red cell concentrate (MAP) since there were only 2 units in the hospital. After bleeding was stopped, the patient was transferred to the ICU while applying pressure for non-active bleeding, and rapid-transfused with 2 units of B(-) MAP, then 10 units of B(+) MAP was added. Anti-Rh antibodies appeared on day 58 and were confirmed to have doubled on day 69 and increased by 8-fold on day 77. Although Rh(+) transfusions are rarely given to Rh(-) patients, Rh-incompatible transfusion should be considered in critical cases after having assessed the patient's history and performed cross-matching.

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