Introduction. Massive transfusion is defined as blood transfusion in
quantities equal to or greater than the estimated patients? blood volume over
a relatively short period of time (3-4 hours). The study was aimed at
analyzing the application of chemotherapy in treatment of patients with acute
massive bleeding and evaluating the results of hemostasis and platelet counts
screening tests in the patients receiving massive transfusions. Material and
Methods. Attempts were made to fully compensate hemostatic factors in 24
patients (14 male and 10 female, aged 23 to 76 years) with acute massive and
uncontrolled surgical bleeding (polytrauma, abdominal aortic aneurysm,
digestive tract bleeding as a result of a farina overdose, mortus fetus) over
the five-year period, wherein a circulating patients? blood volume was
compensated over a relatively short period of time. First the surgical
bleeding was stopped. The objective of chemotherapy was the combined use of
resuspended red blood cells, fresh frozen plasma, cryoprecipitates and the
platelet concentrate in order to maintain the patients? normal circulating
blood volume and blood pressure (systolic blood pressure > 100 mmHg) with
hemoglobin value higher than 100 g/l and the hematocrit above 0.30 l/l.
Results. Transfusion treatment of 24 patients with acute bleeding consisted
of an average of 16 to 18 units of resuspended red blood cells (ranging from
4,880 ml to 5,220 ml); fresh frozen plasma (980 ml to 1,220 ml);
cryoprecipitates (an average of 10 to 15 units i.e. 500-750 ml) and
concentrated platelets (approximately an average of 8 to 12 units i.e. 240 to
360 ml). Conclusion. In our study we have confirmed the pathophysiological
mechanism shown in the available medical literature that after transfusion of
a large red blood cell concentrate volume, dilutional coagulopathy develops,
caused by a sharp drop in platelet count and the significantly reduced
activity of unstable coagulation factors in the patient?s circulation.
Ratio of units of red blood cells to fresh frozen plasma for severely injured patients undergoing massive transfusion
