[Clinical aspects of massive transfusions]

Clinical aspects of massive transfusion (a minimum of 51 blood/6 hours) were investigated in 30 surgical and urological patients. Main bleeding causes were large tumors, liver surgery, prostatectomy and vascular surgery. Two thirds of the patients died, half of them from irreversible hemorrhagical shock. In secondary causes of death were clotting disturbances, renal failure and infections. About 50% of the transfused patients developed hyperbilirubinemia and hypokalemia. The aim of therapy in massively bleeding patients should be a sufficient continuous substitution of blood volume, heated and filtrated blood, heparinisation and balanced substitution of clotting factors.