This study confirms that the enhanced perioperative coagulation mechanism is related to dilution, rather than surgery, and is triggered by rapid crystalloid haemodilution. Consideration should be given to the use of colloid rather than crystalloid solutions for rapid fluid loading in vasculopathic patients undergoing surgery.

No abstract

Red cell transfusions are commonly administered to elderly patients with severe iron-deficiency anaemia. They may be necessary to alleviate severe morbidity until the time at which iron therapy becomes clinically effective. However, greater emphasis should be given to restrictive transfusion strategies and dosing. Transfusion of single red cell units followed by clinical assessment will determine the need for subsequent units and ensure that this valuable resource is appropriately used.

Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion related morbidity and mortality. Current concepts regarding the pathogenesis of this disorder imply a "two-hit" model in which neutrophils are sequestered in the pulmonary capillary bed, and subsequently activated by substances in the transfused blood product. We report a case of TRALI in a patient with neutropenia and discuss the possible factors contributing to the respiratory symptoms in this patient. We also emphasise the importance of recognising mild cases of TRALI in order to investigate the implicated donor/s appropriately, and to minimise the risk for more severe episodes in other patients.