- Free hemoglobin detectable in urine and plasma already at the first micturition (Schoenenberger 2009)
- due to intravascular hemolysis caused by complement activation there is an increase of
- LDH
- Indirect bilirubin
- Decrease of
- haptoglobin
- Hemopexin (only when haptoglobin is no longer measurable)
- Absence of increase in
- erythrocytes
- Hemoglobin
- Hematocrit (Herold 2022)
- Blood cultures
- ABG
- Coagulation status (Schoenenberger 2009)
In particular, the following should be monitored in the presence of HTR:
- Prothrombin time (PTZ)
- fibrinogen
- Activated partial thromboplastin time (aPTT)
- Platelet count (Kasper 2015)
Hemolytic immediate reaction:
The preformed erythrocytic AK causing an immediate reaction can be detected by an indirect Coombs test. This antibody screening test is therefore mandatory for blood grouping and must be repeated at regular intervals if transfusion is required (Herold 2022).
Delayed hemolytic reaction:
These antibodies cannot be detected by an antibody screening test because immunization took place some time ago or the antibody titer is now below the detection limit. In principle, any antibody can cause this reaction, primarily AK against Duffy, Kell and Kidd antigens (Herold 2022).
The direct Coombs test is positive in the majority of those affected (Rump 2003).