[Problems in massive transfusion].

The concept of massive blood transfusion is defined not by the number of units of blood administered but rather by the relationship of the number of blood units transfused to the normal blood volume of the recipient and the rapidity of administration. The composition of stored blood can lead to different metabolic disturbances, specifically in cases of massive transfusion. The importance of hyperkalemia, hypocalcemia and citrate intoxication as well as disturbances in the acid-base balance and blood coagulation as seen in cases of massive transfusion are analysed and the necessary therapeutical consequences discussed.