Restore patient’s hemoglobin to 8–9 g/dL by red cell transfusion
- Provide filtered red blood cells or leucocyte depleted blood 5–12 mL/kg/dose depending on the patients’s clinical severity and levels of anemia
- A close monitoring on total body fluid and cardiovascular status is highly recommended.
-Serial Hb and Hct evaluation should be done at least daily since hemolysis could be continued as the cause has not been removed or properly treated.
Give adequate hydration
- Intravenous fluid therapy should be provided to maintain circulation and withheld during transfusion support.
- The amount and rate should be carefully calculated to avoid possible heart failure from volume overload.
Check blood electrolytes and provide appropriate correction
- Metabolic acidosis is usually observed but mostly resolved by transfusion support and fluid therapy. Only rare cases require alkali therapy.
Try to control body temperature by various means
- Frequent tepid sponge
- Paracetamol 10–12 mg/kg every 4–6 hrs.
- The usage of NSAIDs in hemolytic crisis of Hb H has limited data.
Identify the cause of infection/inflammation and provide appropriate treatment
- Blood and urine culture should be done.
- Empirical antibiotic with the coverage of gram-negative bacteria and/or encapsulated bacteria (depending on splenic condition) such as streptococcus, menigococcus and salmonella sps. should be promptly provided.
Restore patient’s hemoglobin to 8–9 g/dL by red cell transfusion
- Provide filtered red blood cells or leucocyte depleted blood 5–12 mL/kg/dose depending on the patients’s clinical severity and levels of anemia
- A close monitoring on total body fluid and cardiovascular status is highly recommended.
-Serial Hb and Hct evaluation should be done at least daily since hemolysis could be continued as the cause has not been removed or properly treated.
Give adequate hydration
- Intravenous fluid therapy should be provided to maintain circulation and withheld during transfusion support.
- The amount and rate should be carefully calculated to avoid possible heart failure from volume overload.
Check blood electrolytes and provide appropriate correction
- Metabolic acidosis is usually observed but mostly resolved by transfusion support and fluid therapy. Only rare cases require alkali therapy.
Try to control body temperature by various means
- Frequent tepid sponge
- Paracetamol 10–12 mg/kg every 4–6 hrs.
- The usage of NSAIDs in hemolytic crisis of Hb H has limited data.
Identify the cause of infection/inflammation and provide appropriate treatment
- Blood and urine culture should be done.
- Empirical antibiotic with the coverage of gram-negative bacteria and/or encapsulated bacteria (depending on splenic condition) such as streptococcus, menigococcus and salmonella sps. should be promptly provided.