Major haemorrhage

Question 1

How is major haemorrhage defined?

Answer 1

-The loss of one blood volume in 24h
OR
-The loss of 50% of circulating blood volume in 3h
(normal adult blood volume = 7% of body weight)

Question 2

What are the key complications of major haemorrhage?

Answer 2

-Hypothermia
–Transfused blood is refrigerated, impairs homeostasis and causes left-shift of Bohr curve
-Hypocalcaemia
–Citrate anticoagulant in FFP and platelets can bind to calcium
-Hyperkalaemia
–Plasma of red cells stored for 4-5 weeks contain high K+
-Delayed transfusion reaction
–Due to minor incompatibility issues
-Lung injury
–Acute onset pulmonary oedema due to aggregation of leukocyte antibodies in plasma
-Coagulopathy
–Blood volume dilutes and does not replace clotting factors or platelets