SHOT has reported serious hazards of transfusion since 1996. This paper reviews some of the major complications related to transfusion such as transfusion-related acute lung injury, transfusion-associated circulatory overload, transfusion-associated dyspnoea and acute and haemolytic transfusion reactions. Both under-use and over-use of blood and blood components have been reported and the authors emphasise the importance of education in proper use of this resource. The optimal trigger for transfusion in the critically ill is still unknown.

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