Massive blood transfusion exceeding 50 units of plasma poor red cells or whole blood: the survival rate and the occurrence of leukopenia and acidosis

The survival rate after bleeding requiring massive blood transfusions excee ding 50 units has been reported to be low or zero. There seems to be no rep orts of leukopenia in connection with massive blood transfusion. This retrospective study was carried out to investigate the survival rate a nd the occurrence of leukopenia and acidosis in patients who were transfuse d with more than 50 units of plasma poor red cells or whole blood. The survival rate was 16 of 23. Three of the five patients with a blood tra nsfusion of over 100 units survived. Pure component therapy was used on 18 occasions. All patients had a leukopenia, which lasted up to five days. All patients had an acidosis. The range of the lowest pH values in patients wh o did not survive was from 6.77 to 7.27 and in survivors from 6.87 to 7.28. The survival rate was considerably higher than reported in previous studies . Pure component therapy appeared to be particularly suited to massive tran sfusion. Leukopenia was a regular phenomenon. Severe acidosis did not predi ct a poor outcome. (C) 1999 Elsevier Science Ltd. All rights reserved.