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- Title
Robotic hysterectomy in Trendelenburg position in a severely anaemic JKa alloimmunised patient with impending high-outpu.
- Authors
Shah, Shagun Bhatia; Bhargava, Ajay Kumar; Chawla, Rajiv; Pathak, Amardeep
- Abstract
Kidd blood group alloimmunisation, though extremely rare, may produce considerable morbidity, and even mortality. Severe anaemia and impending high-output cardiac failure requiring blood transfusion should be weighed against the risk of severe transfusion reactions even with fully cross-matched blood. Kidd antibodies are a common cause of delayed haemolytic transfusion reaction (DHTR) since they have a tendency remain undetectable in plasma. A low -grade DHTR (second hit) was grossly amplified by a second DHTR (third hit) superimposed on it in our patient leading to severe haemolysis with serum bilirubin reaching 68 mg%. Indirect antiglobulin test (indirect Coombs reaction) should ideally be performed in all patients (scheduled for major surgery requiring blood transfusion) who have experienced a previous pregnancy or blood transfusion. Non-invasive continuous haemoglobin monitoring and non-invasive cardiac output monitoring can prove invaluable tools in management.
- Subjects
HYSTERECTOMY; SURGICAL robots; ALLOIMMUNITY; KIDD blood group system; ANEMIA
- Publication
Indian Journal of Anaesthesia, 2018, Vol 62, Issue 5, p385
- ISSN
0019-5049
- Publication type
Article
- DOI
10.4103/ija.IJA_5_18