Massive blood transfusion exceeding 50 units of plasma poor red cells or whole blood: the survival rate and the occurrence of leukopenia and acidosis

Blood use by inpatient elderly population in the United States

“…Literature we found on massive blood transfusion does not mention amounts of this magnitude. [30][31][32] Validation of these records would be needed, however, to confirm if they are errors.…”

The Use of Fresh Whole Blood in Massive Transfusion

“…Even when blood products are available, preparation and delivery times are finite and can be just as limiting. 6,19,26,27 Under these circumstances, whole blood use can increase the blood bank's ability to deliver lifesaving transfusions in a timely manner. For example, in October 1993, in Mogadishu, Somalia, 125 casualties were incurred in less than 24 hours, at a time when the supporting hospital blood bank was out of blood products.…”

“…12,13,16,17 Data for massive transfusions of trauma patients are much more limited and are inconclusive. 14,25,26,44 The best solution to resuscitating trauma patients is still being sought, and old strategies are being reviewed. Interestingly, in a recent porcine model developed to study hemorrhagic shock, whole blood (autologous) was so effective in resuscitation and survival that it was used as the positive control.…”

“…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.…”