Final answer:
An acute hemolytic transfusion reaction is a severe response occurring within 1 to 24 hours after a mismatched blood transfusion, causing symptoms like fever, hypotension, and hemoglobinuria, and can result in shock or organ failure. Diagnosis includes tests such as blood typing, cross-matching, and DAT. Treatment stops the transfusion and manages symptoms, with prevention including careful matching of blood types and Rh immunoglobulin for Rh incompatibilities.
Step-by-step explanation:
An acute hemolytic transfusion reaction (HTR) typically occurs within the first 24 hours after a patient receives a blood transfusion. This hypersensitivity reaction arises when the recipient's immune system attacks the transfused red blood cells (RBCs), leading to their destruction. The signs and symptoms (S&Sx) of an acute HTR include fever, chills, pruritus (itching), urticaria (hives), dyspnea (difficulty breathing), hemoglobinuria (presence of hemoglobin in the urine), and hypotension (low blood pressure). In severe cases, shock, multi-organ failure, and potentially death can ensue.
The cause of an acute HTR is often due to ABO or Rh factor blood type incompatibility – for example if a person with type B blood receives type A blood. Diagnostic tests for an HTR include blood typing and cross-matching, direct antiglobulin test (DAT), and plasma-free hemoglobin measurement. In the event of an acute HTR, the transfusion must be stopped immediately. Treatment (TX) focuses on managing symptoms and may include intravenous fluids, medications to stabilize blood pressure, and treatment of underlying complications like renal failure.
Preventing future acute HTRs involves careful blood typing and cross-matching before transfusions, and in the case of Rh incompatibility, using Rh immunoglobulin (RhoGAM) to prevent sensitization.