Hemorrhagic Disorder Following Massive Whole Blood Transfusions

The Use of Fresh Whole Blood in Massive Transfusion

“…However, both civilian and military physicians continued to investigate the indications and use of whole blood in the setting of massive transfusion. 7,10,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]44 The clinical situations in which any of these levels of transfusion are needed are imminently life-threatening.…”

“…These complications include quantitative and qualitative thrombocytopenia, dilutional and consumptive coagulopathy, citrate toxicity, hypocalcemia, hyperkalemia, and hypothermia. [25][26][27][28][29][30][31][32][33][34][35][36][37][38] Many of these complications have been attributed to the side effects of component therapy which become exaggerated during massive transfusion. 26 -29,33-34,36,38 These complications have been repeatedly observed, and modern transfusion practice incorporates techniques specifically developed to address these problems.…”

Haemoperitoneum in von Willebrand's Disease

“…At the time, this was thought to be the result of transfusion of stored bank blood (Krevans and Jackson, 1955). Whether posttransfusion thrombocytopenia is due to a simple dilution effect or to actual destruction of platelets by some coagulant in the stored blood, or by virtue of an incompatibility of the platelet group of the recipient and the donor blood, remains a mystery.…”

The Use of Heparinized Blood for Exchange Transfusion in Infants

“…Within 24 hours after exchange transfusion with stored citrated blood, there occurs in many patients a thrombopenia associated with a severe hemorrhagic state. 19 The alteration in anti¬ hemophilic globulin and proaccelerin levels is the result of storing plus the fact that a large percentage of erythroblastotic infants have a deficiency of proaccelerin. '20 When fresh heparinized blood is used, a mild thrombopenia may occur several days after the exchange transfusion20 but it is not accompanied by any hemorrhagic tendencies.…”