ONE OF the problems occasionally encountered in the management of seriously injured casualties is post-transfusion, postoperative hypotension. The syndrome occurs within the first 24 hours after transfusion and operation, developing in the seriously injured casualty who has been resuscitated with difficulty. Characteristically, the hypotension will respond to additional transfusions, although, clinically, the transfusion requirements, being large, may seem out of proportion to blood loss. Less frequently the hypotension will be progressive and refractory to subsequent transfusions and only temporarily responsive to vasoconstrictors. Autopsy of such patients usually revealed an increased weight of the lung.1 This finding suggested the probability of pulmonary edema secondary to cardiac insufficiency.
Post-transfusion hypotension, noted in approximately 10% of a series of 70 dogs after the treatment of hemorrhagic shock with citrated blood, was found to respond to the intravenous injection of calcium lactate.*
Meroney and Herndon,2 working in the Renal Insufficiency Center in