Objective To analyze a case of hyperhemolytic syndrome(HHS)and explore the laboratory diagnostic method and clinical treatment strategy.Methods Serological tests such as blood typing,direct antiglobulin test(DAT),an-ti-screening and antibody identification were performed,The complete blood count(CBC),as well as hemolysis indicators such as lactate dehydrogenase(LDH)and bilirubin were tested,and the changes and progression of hemolysis were moni-tored.By using genotyping methods to test 32 common rare blood type antigens in clinical practice,the accuracy of antibody identification results was supported.Results The patient had anti-E antibodies and autoantibodies in her serum.After blood transfusion,LDH and bilirubin increased significantly,but hemoglobin dropped sharply,far lower than before transfusion,presenting with unique manifestations such as hemoglobinuria.The patient made a full recovery after treatment with high-dose intravenous immunoglobulin and corticosteroids.Conclusion HHS is a rare and potentially fatal diseases,which is mainly manifested by hemolysis and severe anemia,and the hemoglobin level after blood transfusion is often lower than that before blood transfusion.This patient had typical clinical manifestations of post-transfusion hyperhemolytic reaction.After timely and correct treatment,the patient recovered completely and was discharged,accumulating valuable clinical experience for the diagnosis and treatment of such disease.

【Objective】 To evaluate the association between prophylactic plasma transfusion and postoperative bleeding rate in critically ill patients undergoing different invasive procedures. 【Methods】 The information of ICU patients who received different invasive procedures from January 2019 to December 2019 in 6 tertiary hospitals in China were retrospectively investigated. The inclusion criteria of patients were as follows: age ≥ 18 years; received invasive procedures; INR ≥ 1.5 within 72 hours before surgery. Exclusion criteria were patients with incomplete case records. The patients finally included in the study were divided into prophylactic plasma transfusion group and non-prophylactic plasma transfusion group according to their plasma transfusion status. The outcome variable was the incidence of invasive procedure-related bleeding within 48 hours after different invasive procedures. 【Results】 A total of 407 patients underwent invasive procedures, and 362 patients were finally included in this study after excluding 45 patients with incomplete case records. The proportions of prophylactic plasma transfusion in different types of invasive procedures were central venous catheterization (46/146, 31.5%), thoracentesis (13/37, 35.1%), bronchoscopy (8/31, 25.8%), tracheal intubation (9/38, 23.7%), arterial catheterization (9/50, 18.0%) and others (13/60, 21.7%). The bleeding rates showed that different invasive procedures presented no statistical difference between the groups received plasma transfusion or not. In the prophylactic plasma transfusion group, the bleeding rate of arterial catheterization (4/9, 44.4%) was the highest, but all were potential bleeding, followed by tracheal intubation (4/10, 40.0%) and central venous intubation (16/46, 34.8%), with a higher rate of significant bleeding. 【Conclusion】 Prophylactic infusion of plasma did not reduce the bleeding rate after different invasive procedures, but prospective studies are needed to further confirm the conclusion; this study also provides a certain data basis for later prospective studies.