Irregular antibody found during emergency subarachnoid hemorrhage operation : A case report

ABSTRACT

Irregular or unexpected antibodies are alloantibodies against serum or red blood cells after previous exposure to transfusion. When encountered in critical condition, however, risk of ongoing complication is not entirely predictable. Rapid transfusion of safe blood is thus, crucial not to compromise further procedure. A 78-year-old ASA IV man presented with Hunt-Hess grade IV subarachnoid hemorrhage with huge temporal bleeds. While in operating room, his blood pressure dropped when the dura was opened. Meanwhile, routine screening of blood typing repeatedly denoted Rh+O with irregular antibodies. Soon, compatible cross-matched blood was infused with 37 degrees C normal saline 200 ml at a rate of 4-5 ml/kg/hr. There was no laboratory evidence of hemolytic transfusion reaction. Postoperatively, BUN and creatinine increased slightly, but urination and respiration were unremarkable.