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- W2109455430 abstract "The most generally accepted definition of massive transfusion is the replacement of the patient's blood volume in under 24 hours. This corresponds to 3000ml of red cells or approximately 10 units of packed cells in an average weight person. The most frequent reasons for massive transfusion include trauma, GIT bleeding, obstetric bleeding, bleeding abdominal aortic aneurysm, and major elective vascular surgery. Survival in massively transfused patients will vary depending on the underlying disease process. Overall survivals of 45–67% have been reported and of these 90% regain full independence and 75% return to work. Massive transfusion imposes a considerable strain on blood banking resources and in many centres a relatively small number of patients consume 10–15% of the total blood supply annually. Severe coagulopathy (INR and/or APTT double normal) will develop in 40% of patients and severe thrombocytopenia (platelets <50 × 109/L) in 30% of patients between 10 and 20 units of units transfused. Coagulopathy, hypothermia and tissue injury all contribute to the phenomenon of microvascular oozing which develops in approximately 30% of massively transfused patients. There is only a weak correlation between the severity of coagulopathy/thrombocytopoenia and the total units transfused suggesting that factors such as duration of tissue hypoperfusion and consumption are likely to play a more important role than simple haemodilution of coagulation factors. Because of the lack of clear correlation between coagulopathy/thrombocytopenia and the number of units transfused, “formula” replacement with plasma and platelets is not recommended. The approach to blood product support in the massively transfused patient will be discussed." @default.
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- W2109455430 date "2009-08-26" @default.
- W2109455430 modified "2023-09-27" @default.
- W2109455430 title "Massive transfusion: a review" @default.
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- W2109455430 doi "https://doi.org/10.1111/j.1442-2026.1996.tb00540.x" @default.
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