Contributed by Lisa Kohler MD, Iliana Lopez MD, Darrell Triulzi MD
Published on line in June 1997
Disclosure Statement: In accordance with the policies on disclosure of the Accreditation Council for Continuing Medical Education and the Faculty Advisory Committee for Continuing Education in the Health Sciences, University of Pittsburgh, presenters for this program have identified no personal relationships with a health care product company which, in the context of their topics, could be perceived as a real or apparent conflict of interest.
This 58 year old male with a history of renal failure was admitted for continuous hemorrhoidal bleeding with anemia. ADMISSION LABORATORY VALUES (see below) revealed a severe anemia with a prolonged prothrombin time, and uremia. Due to the prolonged prothrombin time (18 seconds), it was decided to treat the patient with fresh frozen plasma(FFP) to correct his coagulopathy and stop the bleeding. He was transfused with 4 units FFP and 4 units packed red blood cells (pRBCs) over less than 6 hours. The patient became hypertensive and dyspneic requiring intubation. Physical examination revealed pulmonary rales and jugular venous distension. The transfusion was terminated and an INVESTIGATION OF REPORTED TRANSFUSION REACTION (see below) was initiated.
|HGB||6.5 mg/dL||HCT||19.2 %||Platelet Count||156.000/ cu mm||WBC||14,200/ cu mm||PT||18 seconds||APTT||32 seconds||BUN||98 mg/dL||Cr||2.8 mg/dL|
|Patient: X. Whyzee||ID: 123-34-4567||DX: Chronic anemia|
|Clerical Accuracy Confirmed:||Pt Identification of Samples |
|Previous reaction:||Yes ___ No _X_|
|Product administered:||Packed RBC's and FFP|
|Date and time of reaction:||---/---|
|PRELIMINARY INVESTIGATION:||Date/Time||Direct AGT||Plasma HGB||Urine|
|Pre reaction specimen||---/---||Neg||Neg||N/A|
|Post reaction specimen||---/---||Neg||Neg||Neg|
|Pre specimen||Type O cells||Rh neg||Neg|
|Post specimen||Type O cells||Rh neg||Neg|