Massive blood transfusion in a tertiary referral hospital. Clinical outcomes and XXXX .

@entity1 @entity556 @entity548 @entity882 @entity532 @entity1003 @entity1028 @entity360 @entity130
OBJECTIVE: To determine blood products used, clinical outcomes and frequency of @entity532 of massive blood transfusion. DESIGN AND SETTING: Retrospective review of the medical records of @entity1 receiving more than 10 units of blood in 24 hours at a tertiary referral hospital in 1993. @entity1 : Forty-three @entity1 fulfilled this criterion. The major reasons for massive transfusion were @entity130 (46%; 20 @entity1 ), @entity360 (21%; nine @entity1 ) and leaking @entity1028 (14%; six @entity1 ). MAIN OUTCOME MEASURES: Blood products used, platelet count ( < 50 x 10(9)/L in first 48 h), @entity556 time (PT) and activated partial thromboplastin time (APTT) (twice normal in first 48 h), @entity548 , and survival. RESULTS: The 43 @entity1 used 824 units of packed cells 15.2% of the total used in 1993), 457 units of fresh frozen plasma (FFP) (17.1% of the 1993 total) and 370 units of platelets (14.8% of the 1993 total). Overall, these @entity1 consumed 16% of the total number of units of blood product used in 1993 for 1478 transfusion episodes. The overall survival rate was 60%. Severe @entity1003 occurred in 19 @entity1 (44%) (mortality rate, 74%), and 13 (31%) had severe @entity882 ( < 50 x 10(9)/L). There was no significant correlation between the severity of @entity1003 / @entity882 and total units transfused, or between the age of the units of blood and development of @entity1003 or @entity548 . CONCLUSIONS: Severe @entity1003 is common after massive transfusions. In the absence of clear correlation with the number of units transfused, "formula" replacement with plasma and platelets is unlikely to avoid the problem. Duration of tissue hypoperfusion and platelet consumption are likely to be more important than simple haemodilution of coagulation factors.
