ABSTRACT
Blood Volume resuscitation of the trauma patient requires repletion of oxygen-carrying capacity with red blood cell transfusion and restoration of intravascular volume to replace extracellular loss. Few would argue that the best resuscitation fluid is blood. It offers the advantage of volume expansion, oxygen transport, and it remains in the intravascular space for prolonged periods. Although transfusion may be necessary to improve tissue oxygenation, multiple studies have shown blood transfusion to be associated with poor outcomes including increased rate of infection, acute respiratory distress syndrome, multiple system organ failure, and death. (31, 32 1B) There are several disadvantages to blood as an initial resuscitation fluid. It must be cross-matched, which requires a specimen from the patient, and time to be prepared by the blood bank. Massive transfusion can cause transfusion reactions, hypocalcemia, hypomagnesemia, dilutional coagulopathy, and systemic immunosuppression. Blood-borne viral pathogens may also be transfused causing hepatitis and HIV.
