In the case of an acute hemolytic transfusion reaction, what is the primary treatment goal?

The primary treatment goal during an acute hemolytic transfusion reaction is to reverse hypotension and minimize renal damage. When an acute hemolytic reaction occurs, the body responds to the foreign red blood cells as if they were an invader, leading to rapid destruction of those cells. This can result in a release of hemoglobin into the bloodstream, which can cause severe complications, particularly in the kidneys.

During this reaction, the kidneys are at significant risk due to the excess hemoglobin which can lead to hemoglobinemia, potentially resulting in acute kidney injury. Therefore, immediate intervention is focused on stabilizing the patient’s blood pressure and ensuring adequate renal perfusion to prevent damage. This typically involves aggressive fluid administration, possibly using diuretics to help maintain urine flow and reduce the concentration of hemoglobin in the renal tubules.

While other treatment goals such as preventing alloimmunization, managing chills and fever, or addressing hemoglobinemia may be important aspects of patient care, they are secondary to the immediate need to address the life-threatening situation of hypotension and protecting the kidneys. The urgency of managing hypovolemia and supporting renal function in this scenario underlines the importance of prioritizing the stabilization of the patient and preventing long-term