| Abstract | | Massive transfusion is commonly defined as transfusion approximating or exceeding more than one half of patient's blood volume within a 24-hour period or 10-20 units of packed red blood cells. More useful definition in the clinical setting defines severe hemorrhage as a rate of blood loss greater than 150 ml per minute, which could lead to the loss of more than one-half of patient's blood volume within 20 minutes. Disease states that may create a need for such large-volume blood replacement include multiple traumatic injuries, cardiac and vascular surgical procedures, hepatic resection or transpalantation, severe injuries of thorax and intraabdominal organs, severe pelvic fractures and disseminated intravascular coagulation. The anesthetizednpatient at typical levels of hypothermia can safely tolerate hematocrits as low as 15%. Patients, who has impaired myocardial or cerebral perfusion should be transfused to maintain a hematocrit of approximately 30%. The complications following massive blood transfusion can be divided in three big groups: in the first group there are the complications which are the consequences of haemodilution and impaired hemostasis or disseminated intravascular coagulation. In the second group are the complication as result of metabolic changes after massive blood transfusion. In the third separed group of the complications are the complications as clerical errors, alergic reactions and the dangerous of infection, which are also present at normal transfusion. But in masive blood transfusion is the situation more dangeroous, because of rapidity, big amount of the blood products and also possibility, that we have to treat more than only one patient simultaneously.
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