Complications of massive transfusion

Area of Science:

• Critical Care Medicine
• Trauma Surgery
• Transfusion Medicine

Background:

• Massive transfusion (MT) is critical for hemorrhagic shock but linked to severe complications.
• The lethal triad (acidosis, hypothermia, coagulopathy) significantly increases mortality.
• Transfusions are associated with organ failure, SIRS, infection, and higher mortality.

Purpose of the Study:

• To review the complications associated with massive transfusion.
• To highlight the risks of MT in trauma, surgery, and critical care.
• To advocate for a restrictive transfusion strategy post-hemorrhage control.

Main Methods:

• Literature review of studies on massive transfusion complications.
• Analysis of data linking blood transfusions to adverse outcomes.
• Synthesis of evidence regarding transfusion strategies.

Main Results:

• MT complications include hypothermia, acid-base/electrolyte derangements, citrate toxicity, and ALI.
• Blood transfusions are independent predictors of MOF, SIRS, infection, and mortality.
• The lethal triad is a major contributor to MT-associated mortality.

Conclusions:

• MT, while lifesaving, presents significant risks and complications.
• A restrictive transfusion approach is recommended after hemorrhage control to mitigate risks.
• Optimizing transfusion strategies is crucial for improving patient outcomes in critical care settings.