Mass transfusion

A mass transfusion (synonym: massive transfusion ) is defined as the replacement of at least one volume of blood in the patient with blood or blood components within 24 hours, i.e. the replacement of the blood volume in 24 hours (5-6 l / 70 kg body weight) or 50% blood exchange a patient within three hours, or the administration of four red blood cell concentrates within one hour if heavy bleeding persists or a blood loss of more than 150 ml blood loss per minute and the corresponding administration of blood products.

Such mass transfusions are usually indicated for multiple trauma with severe hemorrhagic shock . Such an extensive transfusion can cause specific risks that go beyond the risk of a smaller amount of transfusion.

Since the blood products are kept refrigerated, there is a risk that the recipient's body temperature will drop and hypothermia will occur. To prevent this, the blood components can be warmed. The abundant potassium contained in the erythrocyte concentrates from destroyed erythrocytes can lead to hyperkalemia . The citrate added to the red cell concentrates to inhibit coagulation can trigger hypocalcemia ( calcium deficiency). The acid-base balance of the body can also be disturbed.

Such side effects are only to be expected after transfusion of at least one blood volume within three to four hours or at least two blood volumes within 24 hours.

literature

• Rolf Rossaint, Christian Werner, Bernhard Zwissler (ed.): The anesthesiology. General and special anesthesiology, pain therapy and intensive care medicine. 2nd, updated and expanded edition. Springer, Heidelberg 2008, ISBN 978-3-540-76301-7 , p. 792.

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