Anesthesia in Patients with Positive Direct Coombs Test. Report of Three Cases
| Autor: | Dora Catré, Joana Patrícia dos Santos Carvalho, Cláudia Margarida Brito Pereira, Marina Costa |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion DOENÇAS Anemia: hemolítica autoimune Anemia Exploratory laparotomy medicine.medical_treatment BLOOD: transfusion LABORATORIAL TESTS: positive direct Coombs test Coombs test Neoplasms medicine Humans Anesthesia SANGUE: transfusão Aged Blood type Aged 80 and over medicine.diagnostic_test biology business.industry medicine.disease Surgery Coombs Test Anesthesiology and Pain Medicine Blood Grouping and Crossmatching DISEASES Anemia: autoimmune hemolytic Erythropoietin biology.protein Female Autoimmune hemolytic anemia Antibody EXAMES COMPLEMENTARES: teste de Coombs direto positivo business medicine.drug |
| Zdroj: | Brazilian Journal of Anesthesiology. (1):75-83 |
| ISSN: | 0034-7094 |
| DOI: | 10.1016/S0034-7094(10)70009-X |
| Popis: | Summary Background and objectives Neoplasias can be associated with autoimmune hemolytic anemia (AHA) with the consequent blood incompatibility that hinders blood transfusion. The authors describe and discuss the conduct in three patients undergoing surgical intervention for neoplastic disease with positive Coombs Test (CT), and the impossibility to determine the blood type. Case report 1 st case: 87-year old male patient, ASA III, scheduled for surgery for colon neoplasia. The patient had positive CT, being treated with corticosteroids, immunoglobulin (Ig), and erythropoietin, after which it was possible to determine his blood type. One unit of packed-red blood cells (PRBC) was transfused intraoperatively without intercurrences. Twenty four hours after the transfusion, the patient died due to an ischemic stroke. 2 nd case: 77-year old male patient, ASA III, scheduled for surgery for a gastric carcinoma. The patient had a positive CT, being treated with corticosteroids and Ig, but we were unable to determine his blood type. The surgery was performed without intercurrences. The patient died on the 18 th postoperative day after a cardiorespiratory arrest. 3 rd case: 80-year old female patient, ASA IV, undergoing emergency exploratory laparotomy. She also had a positive CT. The surgery (hemicolectomy) was performed without intercurrences. The patient died 48 hours after the surgery from an ischemic stroke. Conclusions Circulating autoantibodies in AHA can make it impossible to determine the blood type to transfuse compatible blood. Proper treatment of AHA is aimed at remission of autoantibodies and anemia. When it is not possible to determine the blood type, the procedure should be a life-saving blood transfusion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|