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Massive transfusions and coagulopathy 

Massive transfusions and coagulopathy
Massive transfusions and coagulopathy

Matthew D. Neal

, Lauren M. McDaniel

, and Raquel M. Forsythe

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date: 22 February 2020

Numerous definitions of massivetransfusion (MT) exist, but it is most commonly defined as the administrationof ≥ 10 units of packed red blood cells (pRBCs) to a patient in a single 24-hourperiod. The need for MT in the ICU arises most commonly in the setting oftraumatic injury because 3%–5% of all civilian trauma patients go on to require MT. Postoperative hemorrhage, postpartum complications, complex electivevascular and transplantation surgery, and acute gastrointestinal bleeding arealso frequent triggers for massive transfusion. This chapter will discussthe approach to MT for the patient presenting with hemorrhagic shock, with afocus on the evidence-based approach to hemostatic resuscitation as well as theimportant consequences and complications that must be closely monitored bythe ICU clinician.

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