Transfusion medicine
Transfusion side effects
Massive transfusion

Topic Completed: 1 October 2011

Revised: 5 April 2019

Copyright: 2002-2017,, Inc.

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

Nat Pernick, M.D.
Page views in 2018: 28
Page views in 2019 to date: 20
Cite this page: Pernick N. Massive transfusion. website. Accessed June 20th, 2019.
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

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Massive transfusion protocols (MTP)

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