Massive blood transfusion

Katharine Downes, Ravindra Sarode

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Pediatricians in the hospital setting must frequently treat children who require massive transfusion (MT) in a variety of clinical situations ranging from major trauma to neonatal hyperbilirubinemia. After identifying the need for massive transfusion, the pediatrician must select the appropriate blood components. Different blood components have specific temperature, preservative, and time requirements for their storage. Changes, termed storage lesions, occur over time in blood components during storage; biochemical changes include decreased levels of 2,3-DPG, a decrease in pH, and an increase in supernatant potassium (K+) with a concurrent decrease in intracellular K+. These changes may affect the function and the viability of components. Additionally, physical changes such as deformation of the red cell membrane occur during storage. Knowledge of these storage lesions is necessary for the pediatrician to make the most appropriate decisions regarding the preparation and selection of components during MT. Serious complications of MT include hemostatic abnormalities, biochemical/ metabolic abnormalities, hypothermia, mechanical injury and the effect of Rh incompatibility, each of which has a specific management response. Pediatricians need to be aware of the potential complications associated with massive transfusion, to take measures to prevent them when possible, to anticipate additional transfusion requirements, and to know how to manage them in the pediatric patient.

Original languageEnglish (US)
Pages (from-to)145-149
Number of pages5
JournalIndian journal of pediatrics
Volume68
Issue number2
StatePublished - Feb 1 2001

Keywords

  • Citrate toxicity
  • Coagulopathy
  • Massive transfusion
  • Storage lesions

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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