Massive Transfusion
Description
Massive transfusion is generally defined as the rapid administration of large volumes of blood (in an adult, >5 L, ≥10 units RBC's, or >1 blood volume) in a 24-hour period. This may result in several adverse effects which must be monitored and corrected in order to minimize patient mortality and morbidity.
Clinical Presentation
Complications of massive transfusion are dependent on the number of units transfused, the rate of transfusion, and factors intrinsic to the patient. They can be discussed in three categories:
- Hypothermia
- Metabolic
- Hemostatic
Massive Transfusion Policies
Many hospitals have policies that allow for:
- Abbreviated crossmatch methods when the amount equivalent to blood volume has been given within 24 hours (this is usually 10-12 red blood cell units for an adult).
- Switching to another compatible ABO blood type when group specific blood components are unavailable.
- Switching Rh negative patients to Rh positive blood components when Rh negative blood components are unavailable or in short supply.