[Massive blood transfusion in 50 seriously injured patients. Occurrence of pulmonary oedema (author's transl)].

This retrospective study shows correlations between the occurrence of pulmonary and massive blood transfusion in 50 seriously injured patients. They received massive transfusions on an average of 13 titers (minimum 51, maximum 30 l) including from 0 to 7,51 of macromolecular solutions (average 2,43 1). These seriously injured patients were divided into 4 groups: --20 thoracic injured patients with associated abdominal lesions, --15 thoracic injured patients without any abdominal lesions, --4 peripheral traumatism with abdominal lesions, --11 polytraumatic patients (considering only lesions of the limbs). There is a significant difference between seriously injured patients with associated abdominal lesions who were transfused and the other groups studied. Sixteen patients experienced pulmonary edema the diagnosis of which was reinforced on grounds of clinical, biological and radiological evidences. Significant difference (p:minor 0,05) were noted as regard the incidence of pulmonary edema when comparing the volume of fluids administrated to the different groups. New out of 16 patients died, mainly because of refractory hypoxia. When more than 25 liters of fluids are transfused, the prognosis is poor. Though pulmonary edema may be brought about by transfusion, other etiologic possibilities are to be investigated.