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July 1967

Massive Blood Replacement

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