Complications of massive transfusion

Massive transfusion (MT) is a lifesaving treatment of hemorrhagic shock, but can be associated with significant complications. The lethal triad of acidosis, hypothermia, and coagulopathy associated with MT is associated with a high mortality rate. Other complications include hypothermia, acid/base d...

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Bibliographic Details
Published inChest Vol. 137; no. 1; p. 209
Main Authors Sihler, Kristen C, Napolitano, Lena M
Format Journal Article
LanguageEnglish
Published United States 01.01.2010
Subjects
Blood Coagulation
Blood Coagulation Disorders - blood
Blood Coagulation Disorders - etiology
Blood Transfusion - mortality
Humans
Multiple Organ Failure - blood
Multiple Organ Failure - etiology
Prognosis
Risk Factors
Shock, Hemorrhagic - therapy
Survival Rate
Systemic Inflammatory Response Syndrome - blood
Systemic Inflammatory Response Syndrome - etiology
Thrombocytopenia - blood
Thrombocytopenia - etiology
Transfusion Reaction
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Summary:Massive transfusion (MT) is a lifesaving treatment of hemorrhagic shock, but can be associated with significant complications. The lethal triad of acidosis, hypothermia, and coagulopathy associated with MT is associated with a high mortality rate. Other complications include hypothermia, acid/base derangements, electrolyte abnormalities (hypocalcemia, hypomagnesemia, hypokalemia, hyperkalemia), citrate toxicity, and transfusion-associated acute lung injury. Blood transfusion in trauma, surgery, and critical care has been identified as an independent predictor of multiple organ failure, systemic inflammatory response syndrome, increased infection, and increased mortality in multiple studies. Once definitive control of hemorrhage has been established, a restrictive approach to blood transfusion should be implemented to minimize further complications.
ISSN:1931-3543
DOI:10.1378/chest.09-0252