Case report reveals acute hemolytic transfusion reaction in a trauma patient, highlighting transfusion mismatch as a critical differential diagnosis during post-resuscitation coagulopathy.
A 15-year-old critically injured male was transferred to the trauma management center after a road traffic accident. The patient had sustained a head injury with a lower limb crush injury and underwent massive blood loss before hospitalization. During acute trauma resuscitation, he was transfused massively both in the intra-operative and post-operative period with ABO-incompatible blood. The patient developed hemolysis and disseminated intravascular coagulation related signs which were not differentiated from the sequelae of poly-trauma and its complication earlier. The clinical status of the patient was not improving even after following the treatment protocols for trauma management. Later it was revealed that the clinical condition was attributed to incompatible blood transfusion due to wrong blood in the tube for the pre-transfusion group testing sample. In conclusion, the possibility of transfusion mismatch can be a differential in non-responding trauma patients who develops features of coagulopathy.
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Krishna et al. (2024) studied this question.
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