MASSIVE BLOOD TRANSFUSION

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MASSIVE BLOOD TRANSFUSION:

MASSIVE BLOOD TRANSFUSION

KONDISI APA YANG DISEBUT TRANSFUSI MASIF:

KONDISI APA YANG DISEBUT TRANSFUSI MASIF Volume related Transfusion of at least one blood volume (10 or more units) within 24 hours OR acute administration of > 4 RBC concentrates within I hr

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Rate related Any transfusion which involves the administration of blood in which 10% of the blood volume is replaced in 10 minutes or less (50 ml/min in an average adult)

SITUASI YANG MEMBUTUHKAN TRANSFUSI MASIF:

SITUASI YANG MEMBUTUHKAN TRANSFUSI MASIF Major trauma Major vascular surgery Major cardiac surgery Major hepatic surgery Major craniofacial surgery Radical oncological surgery Spinal instrumentation

KASUS:

KASUS Laki-laki 25 th dilakukan operasi cito untuk laparotomi eksporasi setelah mengalami kecelakaan tunggal saat mengendarai sepeda motor.Nadi 140 x/m dan TD 75/45 dengan abdomen distended hebat. Tampak sesak, pucat dan gelisah. Ditemukan perdarahan yg berasal dari robekan liver dan lien ruptur parsial. Diperlukan pemberian cairan dan darah dalam waktu cepat dan banyak

Apa yang menjadi target kita?:

Apa yang menjadi target kita? Maintain intravascular volume Try and maintain O2 carrying capacity Hemostasis as soon as possible

WHAT BASELINE LABS SHOULD BE ORDERED?:

WHAT BASELINE LABS SHOULD BE ORDERED?

CASE SCENARIO:

CASE SCENARIO Anaesthesia induction done You have managed to get IV access with 2 cannulas A sample for crossmatch was sent from ER and 6 units of packed cells are immediately available The surgeon has managed to clamp the splenic pedicle,by this time you have given 4 units of packed cells,3 litres of crystalloids and one litre of colloids

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The surgeon is unable to control the bleeding from the liver lacerations and the patients BP still remains low You have managed to get an external jug line in and have requested further 6 units of blood You administer 3 more units and more crytalloids,the BP is stabalizing but you notice an ooze from IV sites What is the most common complication that you will expect at this stage?

WHAT IS THE MOST COMMON COMPLICATION?:

WHAT IS THE MOST COMMON COMPLICATION? Dilutional coagulopathy Acid base disturbance Hypothermia Electrolyte disorders Citrate load Microembolization Other complications related to BT

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