Background
The concept of massive transfusion was developed to trigger clotting factor therapy for the treatment of coagulopathy due to dilution, after a certain number of units of packed red blood cells. It has been defined as the replacement of circulating volume or the transfusion of more than 6 or 10 units of packed red blood cells (PRBC) in the 24 hours after injury. Until recently there has been little consideration of the transfusion of clotting products. Given the recent identification of the early coagulopathy of trauma and the new therapeutic regimens for massive transfusion, there is therefore a need to re-examine the concept of massive transfusion.