Irregular antibody found during emergency subarachnoid hemorrhage operation : A case report

Cheong, Mi Ae; Yi, Si Min; Son, Sung Il; Kim, Dong Won; Shim, Jae Chul; Suh, Jung Kook; Yi, Hyeong Joong

Case Report

Neuroanesthesia

Anesthesia and Pain Medicine 2009;4(1):40-42.
Published online January 30, 2009.

Irregular antibody found during emergency subarachnoid hemorrhage operation : A case report

Mi Ae Cheong, Si Min Yi, Sung Il Son, Dong Won Kim, Jae Chul Shim, Jung Kook Suh, Hyeong Joong Yi

¹Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea. dongwkim@hanyang.ac.kr
²Department of Neurosurgery, Hanyang University College of Medicine, Seoul, Korea.

Abstract

Irregular or unexpected antibodies are alloantibodies against serum or red blood cells after previous exposure to transfusion. When encountered in critical condition, however, risk of ongoing complication is not entirely predictable. Rapid transfusion of safe blood is thus, crucial not to compromise further procedure. A 78-year-old ASA IV man presented with Hunt-Hess grade IV subarachnoid hemorrhage with huge temporal bleeds. While in operating room, his blood pressure dropped when the dura was opened. Meanwhile, routine screening of blood typing repeatedly denoted Rh+O with irregular antibodies. Soon, compatible cross-matched blood was infused with 37 degrees C normal saline 200 ml at a rate of 4-5 ml/kg/hr. There was no laboratory evidence of hemolytic transfusion reaction. Postoperatively, BUN and creatinine increased slightly, but urination and respiration were unremarkable.

Key Words: hemolytic transfusion reaction, irregular antibodies, transfusion