University of Michigan School of Medicine, Ann Arbor, MI 48109-0033, USA.
Chest. 2010 Jan;137(1):209-20. doi: 10.1378/chest.09-0252.
Massive transfusion (MT) is a lifesaving treatment of hemorrhagic shock, but can be associated with significant complications. The lethal triad of acidosis, hypothermia, and coagulopathy associated with MT is associated with a high mortality rate. Other complications include hypothermia, acid/base derangements, electrolyte abnormalities (hypocalcemia, hypomagnesemia, hypokalemia, hyperkalemia), citrate toxicity, and transfusion-associated acute lung injury. Blood transfusion in trauma, surgery, and critical care has been identified as an independent predictor of multiple organ failure, systemic inflammatory response syndrome, increased infection, and increased mortality in multiple studies. Once definitive control of hemorrhage has been established, a restrictive approach to blood transfusion should be implemented to minimize further complications.
大量输血（MT）是失血性休克的救命治疗方法，但可能会伴随严重的并发症。与 MT 相关的酸中毒、低体温和凝血功能障碍的致死三联征与高死亡率相关。其他并发症包括低体温、酸碱平衡紊乱、电解质异常（低钙血症、低镁血症、低钾血症、高钾血症）、枸橼酸盐毒性和输血相关的急性肺损伤。在多项研究中，创伤、手术和重症监护中的输血已被确定为多器官衰竭、全身炎症反应综合征、感染增加和死亡率增加的独立预测因素。一旦明确控制出血，就应采用限制性输血方法，以尽量减少进一步的并发症。
