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June 16, 1951


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615 Third St., Brooklyn 15.

JAMA. 1951;146(7):672. doi:10.1001/jama.1951.03670070064027

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To the Editor:  —In reference to the article "Successful Treatment of Mismatched Blood Transfusion," by Varney et al. (J. A. M. A. 145:978 [March 31] 1951), I believe certain facts regarding hemolytic transfusion reactions should be noted. I do not believe alkalinization of the urine is of any use in the treatment of anuria due to so-called lower nephron nephrosis, nor do I believe precipitation of acid hematin is an important factor in the causation of this condition. It has been shown that overburdening of the patient with intravenous fluids, in the amount indicated in the case report, is a most frequent cause of cardiac failure, pulmonary edema, and death.The important steps in the management of hemolytic transfusion reactions are first, relief of anoxemia by raising of the hemoglobin to normal values with transfusion of compatible whole blood or packed red blood cells; second, restriction of fluids to

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