[Therapeutic problems after massive blood transfusions]

The term of massive blood transfusion is still today not clearly defined. Through the introduction of microfilters, however, the clinical problems were decisively reduced. Nevertheless, a persistent shock may also today lead to acute respiratory disease. Further difficulties present the buffering, the slow activation of erythrocyte function in stored blood, the sufficient fluid and electrolyte substitution as well as the observation of renal function and coagulation disturbance. The problems of rewarming the patient and warming the stored blood before transfusion are discussed. Special regard must be paid to early and long enough ventilation during and after massive blood transfusion.