A successful treatment of rhesus positive transfusion in traumatic brain injury patient with rhesus negative: A case report

Abstract

Management of Traumatic Brain Injury (TBI) aims to prevent secondary brain injury from factors such as hypoxia, hypotension, and anemia. Transfusion is one of the treatments for anemia in patient with TBI. However, unexpected side effects might occur as a result of transfusion, especially transfusion using different rhesus (Rh). Herein, we reported a 33-years-old male Rh(-) patient who suffered from TBI and anemia, receiving a different Rh transfusion due to stock unavailability and emergency condition. A Focused Abdominal Scan for Trauma (FAST) examination did not discover any fluid in the abdominal cavity. Head CT-scan found intracerebral hemorrhage (ICH) in the right frontotemporal. Legs x-ray found inter trochanter fracture on the right femur. Open reduction and internal fixation (ORIF) plating surgery was conducted to manage the intertrochanter fracture. This patient received 4 bags of blood product type B with Rh(+). After undergoing intensive observation and several more surgeries, the patient survived. In an emergency, patient with Rh(-) who requires blood transfusion but is faced with stock unavailability should considered using Rh(+) blood transfusion to prevent worsening of their condition. Blood product transfusions with different rhesus must be given with the utmost caution and close monitoring to avoid triggering a transfusion reactions.