A hemolytic blood transfusion reaction occurs when a patient receives blood that does not match his own. In order for the body to accept donor blood, it must be of the same type. A patient who has a blood type of A negative cannot receive blood from someone who is B positive because the body will perceive this blood as a foreign invader and begin to attack the cells. When antibodies attack the blood cells, they will burst releasing toxins into the bloodstream, causing a severe reaction. Treatment for a hemolytic reaction involves treating the symptoms that the reaction caused.
Stop the Transfusion
Nurses or physicians can spot a hemolytic reaction most often within the first 5 to 10 minutes of receiving the transfusion. Most commonly, registered nurses monitor the patient closely for the first 15 minutes of a transfusion to look for signs of a reaction such as fever, bloody urine, rash and itching, welts and pain in the back or chest. A nurse suspecting a transfusion reaction will stop the transfusion immediately. The nurse will collect blood samples from the patient and the donor blood and send it to the lab for testing to determine the cause of the reaction.
Antihistamine Drugs
When antibodies attack foreign cells, it produces a histamine response, which presents with allergy symptoms like itching, welts or rash. According to the "New York Times," after the transfusion is stopped, patients often receive an injection of diphenhydramine to combat these symptoms. Diphenhydramine side effects include sleepiness, drowsiness, and dry mouth and throat.
Corticosteroids
Physicians will often prescribe corticosteroids such as prednisone or dexamethasone to reduce the immune response, according to the National Institutes of Health. Corticosteroids work by mimicking the effects of hormones released by the adrenal glands, which suppress inflammation and can reduce inflammatory response. Side effects of corticosteroids include elevated pressure in the eyes, fluid retention in the lower legs, increased blood pressure and weight gain around the face, abdomen and back of the neck.
Maintain Kidney Function
The University of Maryland Medical Center explains that after a hemolytic reaction, patients commonly receive fluids given through an intravenous catheter in order to prevent kidney failure and shock. Patients will receive an infusion of normal saline to maintain proper fluid volume within the body. Physicians may choose to add medications such as furosemide and low-dose dopamine to increase renal blood flow and prevent kidney failure.
