title: [A case of leukocytosis after massive blood transfusion for postpartum hemorrhagic shock].
abstract: We experienced the perioperative management of a hemorrhagic shock associated with postpartum uterine rupture. After the emergency abdominal total hysterectomy, massive blood transfusion was required to maintain the hemodynamics and the laparotomy for hemostasis was performed on the 1st, 2nd and 7th ICU day. Total amount of transfused blood products was 37,000 ml during one week. The patient immediately developed DIC and acute renal failure. Laboratory data showed increased leukocyte count (the peak value was 56,100 microliters-1 on the 12th ICU day), and neutrophilic fraction was more than 90% of leucocyte. After the decrease in CRP, the decrease in total bilirubin concentration was delayed. There were no other signs of infection and no remarkable change in MOF score. There was a discrepancy between this leukocytosis and the severity of organ dysfunction, and the cause of the leukocytosis was unknown.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine.
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: S
authors.initials: S
authors.lastname: Akamatsu
authors.forename: M
authors.initials: M
authors.lastname: Takada
authors.forename: H
authors.initials: H
authors.lastname: Shimonaka
authors.forename: S
authors.initials: S
authors.lastname: Dohi
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy; D007964:Leukocytosis / Q000209:etiology*; D008875:Middle Aged; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000628:therapy; D065227:Transfusion Reaction; D014597:Uterine Rupture / Q000150:complications* / Q000601:surgery