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Priorities in massive transfusion1 Replace and maintain blood volume 2 Maintain haenmostasis: Platelet count (>50 x 109/l) Coagulation factors 3 Optimise oxygen carrying capacity: Maintain packed cell volume > 20 4 Correct or avoid metabolic disturbances: Hypocalcaemia Hyperkalaemia Acid-base disturbance Hypothermia 5 Maintain plasma colloid osmotic pressure
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Hewitt et al. (1990) studied this question.
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