What is the treatment for a hemolytic transfusion reaction?

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Last updated: February 10, 2025View editorial policy

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From the Guidelines

The treatment for a hemolytic transfusion reaction is to immediately stop the transfusion and manage the patient's symptoms, which may include administration of antihistamine or steroid drugs, or intramuscular/intravenous adrenaline if life-threatening 1.

Key Steps in Management

  • Stop the transfusion immediately if a reaction is suspected
  • Monitor the patient's vital signs, including heart rate, blood pressure, temperature, and respiratory rate
  • Administer antihistamine or steroid drugs to manage mild to moderate reactions
  • Use intramuscular/intravenous adrenaline in life-threatening situations
  • Contact the laboratory immediately to report the reaction and seek further guidance 1

Importance of Prompt Action

Prompt recognition and treatment of a hemolytic transfusion reaction are critical to preventing serious complications and improving patient outcomes. The administration of antihistamine or steroid drugs, or intramuscular/intravenous adrenaline, can help alleviate symptoms and prevent further deterioration 1.

From the Research

Treatment for Hemolytic Transfusion Reaction

The treatment for a hemolytic transfusion reaction involves several key steps:

  • Immediate interruption of the transfusion 2
  • Early identification of symptoms and referral to the hemovigilance reporting system 2
  • Early consultation of the hematologic and ICU departments 2
  • Fluid resuscitation 2
  • Monitoring of the patient's vital signs and laboratory results, such as hemoglobin, hematocrit, and creatinine levels 3

Management of Hemolytic Transfusion Reaction

The management of a hemolytic transfusion reaction requires a comprehensive approach, including:

  • Recognition of symptoms, such as fever, flank pain, and red or dark urine, although these may not be immediately visible in patients under anesthesia 3
  • Identification of other signs, such as seeping from venipuncture and dark urine caused by DIC and hemoglobinuria 3
  • Awareness of the risk of transfusion-associated circulatory overload and other adverse reactions 4
  • Education on the risk of transfusion-associated graft-versus-host-disease (TA-GVHD) and other rare but serious complications 4

Prevention of Hemolytic Transfusion Reaction

Prevention of hemolytic transfusion reactions is crucial, and can be achieved through:

  • Avoiding unnecessary blood transfusions and maintaining a transfusion-restrictive strategy 2
  • Conducting cross-matching tests to prevent acute hemolytic transfusion reactions 4
  • Ensuring careful monitoring of the patient during transfusion and prompt recognition of any symptoms or signs of a reaction 5, 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Understanding and management of adverse transfusion reactions].

[Rinsho ketsueki] The Japanese journal of clinical hematology, 2023

Research

Hemolytic transfusion reaction: safeguards for practice.

Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses, 2002

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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