Transfusion medicine
Transfusion side effects
Massive transfusion

Author: Nat Pernick, M.D. (see Authors page)

Revised: 26 October 2017, last major update October 2011

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Massive transfusion [title] "loattrfree full text"[sb]

Cite this page: Pernick, N. Massive transfusion. website. Accessed October 17th, 2018.
Definition / general
  • Transfusion greater than 1 blood volume (70 mL/kg in adults, 85 - 100 mL/kg in neonates) or 10 units of blood in an adult in 24 hours
  • May cause coagulopathy due to decrease in fibrinogen, also acidosis (Chest 2010;137:209)
  • May cause hypothermia if red cells are not warmed prior to transfusion, leading to prolongation of PT and PTT and impaired platelet function
  • Onset and severity of coagulopathy may differ in elective surgery versus trauma (Vox Sang 2005;89:123)
  • Needed for 3 - 5% of trauma patients
  • Extensive departmental coordination required to implement protocols (J Trauma 2010;68:1498)
  • Standardized massive transfusion protocols for substantial hemorrhage: able to be executed rapidly with reduction in waste of blood products (Transfus Med Rev 2011;25:293)
Diagrams / tables

Images hosted on other servers:

Massive transfusion protocols (MTP)