Coagulation Defects Associated with Massive Blood Transfusions

Miller, Ronald D.; Robbins, Thomas O.; Tonc, Myron J.; Barton, Silas L.

doi:10.1097/00000658-197111000-00010

Cited by 225 publications

(52 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most studies describing dilutional thrombocytopenia after major hemorrhage were carried out using whole (or modified whole) blood [33, 34, 35]. Some reports involved shocked patients undergoing emergency surgery and it may be problematic to extrapolate findings to stable patients undergoing elective surgery [27].…”

Section: Discussionmentioning

confidence: 99%

“…Some reports involved shocked patients undergoing emergency surgery and it may be problematic to extrapolate findings to stable patients undergoing elective surgery [27]. Pediatric and adult studies demonstrated that platelet count declined logarithmically during massive whole blood transfusions [25, 33, 34]. However, measured platelet count after hemodilution usually exceeded the predicted value, possibly because of mobilization of platelets from extravascular sites [25].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, median platelet counts for both groups remained greater than 100 K/mm –3 at all sampling times. If platelet function is reasonable, bleeding usually does not occur until a platelet count of less than 50 K/mm –3 is encountered [25, 33, 37]. For groups A and B at all sample times, median TEG maximum amplitude was 38 mm or greater, suggesting that platelet function was adequate.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Abnormal Coagulation during Pediatric Craniofacial Surgery

Williams¹,

Ellenbogen

Gruss

2001

Pediatr Neurosurg

View full text Add to dashboard Cite

Introduction: This prospective study of children undergoing major craniofacial surgery was undertaken to determine whether abnormal hemostasis occurred and to characterize any coagulopathy found. Methods: Coagulation tests, blood loss and blood product transfusions were recorded perioperatively. Packed red blood cells (PRBC) were transfused to maintain target hematocrit. Patients with blood loss >100 ml/kg (group A, n = 5) were compared to patients with blood loss <100 ml/kg (group B, n = 22) using Mann-Whitney U test (p < 0.05). Results: Twenty-seven children (age range 2.9–27.9 months) had median total blood loss of 64 ml/kg. At completion of surgery, median coagulation values differed significantly between groups for prothrombin time (A: 16.6 s; B: 13.8 s), partial thromboplastin time (A: 44 s; B: 29 s), thrombin time (A: 28 s; B: 23 s), thromboelastograph reaction time (A: 7 mm; B: 4 mm), prothrombin fragment F1.2 (A: 1.9 nmol/l; B: 3.3 nmol/l) and platelet count (A: 174 K/mm^–3; B: 239 K/mm^–3). Fibrinolysis was not associated with blood loss. Median units transfused were in group A 3 units and group B 1 unit (p = 0.001). All patients received PRBC transfusions but only group A patients received other blood products (fresh frozen plasma, platelets). Conclusion: Children transfused with PRBC during craniosynostosis repair can become coagulopathic from coagulation factor depletion when hemorrhage approaches 1.5 times estimated blood volume.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Abnormal Coagulation during Pediatric Craniofacial Surgery

Williams¹,

Ellenbogen

Gruss

2001

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…However, both civilian and military physicians continued to investigate the indications and use of whole blood in the setting of massive transfusion. 7,10,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]44 The clinical situations in which any of these levels of transfusion are needed are imminently life-threatening.…”

mentioning

confidence: 99%

“…These complications include quantitative and qualitative thrombocytopenia, dilutional and consumptive coagulopathy, citrate toxicity, hypocalcemia, hyperkalemia, and hypothermia. [25][26][27][28][29][30][31][32][33][34][35][36][37][38] Many of these complications have been attributed to the side effects of component therapy which become exaggerated during massive transfusion. 26 -29,33-34,36,38 These complications have been repeatedly observed, and modern transfusion practice incorporates techniques specifically developed to address these problems.…”

mentioning

confidence: 99%