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[Anaesthesia problems in massive transfusion (author's transl)].

B Landauer

    Der Anaesthesist
    |May 1, 1978
    PubMed
    Summary
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    Proper anesthesia during massive blood transfusions requires avoiding leftward shifts in oxygen dissociation. Careful management of acidosis, blood warming, and crystalloid use is crucial for patient safety.

    Area of Science:

    • Anesthesiology
    • Critical Care Medicine
    • Transfusion Medicine

    Context:

    • Massive transfusions are critical in trauma and surgery.
    • Maintaining physiological balance during massive transfusion is complex.
    • Potential complications include oxygen-hemoglobin dissociation shifts and coagulopathy.

    Purpose:

    • To outline anesthetic strategies for patients undergoing massive transfusion.
    • To highlight key considerations for preventing complications.
    • To provide guidance on managing oxygen transport and coagulation.

    Summary:

    • Avoid hyperventilation and overcorrection of metabolic acidosis to prevent leftward shifts in oxygen dissociation.
    • Coagulation disorders are often overestimated; avoid 'blind' substitution.

    Related Experiment Videos

  • Use blood microfilters and limit crystalloid solutions like Ringer's lactate to prevent pulmonary insufficiency.
  • Avoid irritating anesthetics (halothane, methoxyflurane) and utilize PEEP.
  • Ensure circulatory stability with ketamine/fentanyl and pancuronium for relaxation.

    • Impact:

    • Optimized anesthetic management can improve outcomes in massive transfusion patients.
    • Reduced incidence of transfusion-related complications.
    • Enhanced understanding of physiological management during massive transfusion protocols.