Aliases:
Massive blood transfusion

Topic aliases are alternate phrasings for a particular topic.


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Definitions vary. Anesthetic concerns are recognising the need for transfusion, logistical issues with supply and administration, and maintaining optimal coagulation profile with proportional blood products and normothermia.

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Nov 05, 2011
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- In adult patients, a transfusion of half of one blood volume in 4 hours, or more than one blood volume in 24 hours (adult blood volume is approx 70mls/kg)

- In children, a transfusion of more than 40mls/kg (blood volume of children older than a neonate is approximately 80mls/kg)

www.rch.org.au/bloodtrans...

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Mar 14, 2013
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Definition: More than 4 units of packed red blood cells in 1hr and expecting to give more, or replacement of total blood volume in 24hrs. #ref

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Jul 16, 2011
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Each hospital should have a massive transfusion protocol. Activate this to ensure that available products are mobilised and supplied in correct proportion to maintain proper coagulation status.

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Jun 13, 2011
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Ensure administered fluids are warm. Each liter of cold fluid decreases core temp by 0.25 degrees. #ref

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Jun 13, 2011
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Solutions containing calcium ( Haemaccel, Hartmann's and lactated Ringer's solution and Gelafusal (available in New Zealand)) should not be administered with blood components which are collected in citrate medium as they may cause clotting of the infusion line.

5% glucose (dextrose) in water or hypertonic sodium solutions should not be used as they may cause red cells to haemolyse

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Jul 18, 2016
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Hypocalcemia results from citrate toxicity after ~5units. Measure and replace calcium early.

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Hypomagnesemia may result from transfusion of magnesium deplete fluids or citrate binding. Clinically this may manifest as a prolonged QT.

British Committee for Standards in Haematology, Stainsby D, MacLennan S, Thomas D, Isaac J, Hamilton PJ. Guidelines on the management of massive blood loss. Brit J Haematol. 2006;135(5):634-41. doi: 10.1111/j.1365-2141.2006.06355.x

Mount D. Causes of hypokalaemia. In: Sterns R, Forman J, editors. UpToDate. Waltham (MA): UpToDate; 2012.

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Jul 18, 2016
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Avoid hypothermia. This will exacerbate coagulopathy. Monitor core temperature, warm all fluids, use warming blanket, and warm room.

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Jul 16, 2011
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Detailed handover to ICU of all measures taken to maintain hemostasis.

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Nov 22, 2011
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Adult massive transfusion implementation tool at Southern Health

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Mar 12, 2012
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Massive transfusion protocol at the Royal Children's Hospital Melbourne

www.rch.org.au/bloodtrans...

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