July 1967

Massive Blood Replacement

Author Affiliations

Kansas City, Kan
From the Department of Surgery, University of Kansas Medical Center, Kansas City, Kan. Drs. Vogel and Frederickson are now at Emory University, Atlanta.

Arch Surg. 1967;95(1):38-43. doi:10.1001/archsurg.1967.01330130040008

MASSIVE BLOOD replacement is an increasing reality and necessity. The surgeon's increasing boldness in the surgical treatment of cancer and cardiovascular abnormalities, the development of a light general anesthetic technique, and the rising incidence of massive trauma have resulted in the administration of bank blood at rates and in amounts not considered practical only a few years ago.

Massive blood replacement, although it may be lifesaving, is associated with a rising mortality rate as the amount of blood given increases.1 In one series a mortality rate of 85% has been reported in patients receiving more than 11 units of bank blood in 24 hours.2 In another series the mortality rate was 25% after 12 units of bank blood had been given, and 50% after 20 units.3 Both of these series were reported in 1955. In 1965, Howland et al4 reported a series of patients in which

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