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Acid-Base Balance Changes in Citrated Bank Blood

SHLOMO L. SAMUELOFF, MD; EDMUND M. LUTTWAK, MD; BATHSHEVA M. WIGDERHOUSE, MD
Arch Surg. 1963;87(6):1029-1032. doi:10.1001/archsurg.1963.01310180145024.
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Since massive transfusions of citrated bank blood have become a widely accepted practice in surgery, the interest in the changes occurring in the recipient's blood has increased.3 In connection with this problem some reports on acid-base balance changes resulting from transfusions have been published.4 Litwin, Smith, and Moore5 have shown the occurrence of metabolic alkalosis after massive blood transfusions, even though the citrated blood shows a pH of 7.0 (Gibson et al2). This post-transfusion metabolic alkalosis has recently been confirmed by Schweizer and Howland.7 A number of clinical cases under our observation have shown a similar trend after massive transfusions (8-20 units), though, upon infusion of moderate amounts (1-3 blood units), the changes remained in the range of normal variations in acid-base balance.

While data relating to the recipient's blood changes are accumulating, it appears that information pertinent to the acid-base balance characteristics of the

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