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Profound Intraoperative Hypotension Associated With Transfusion via the Belmont Fluid Management System

Miller, Joanna MD*; Kim, Sang MD; Adelmann, Dieter MD; Hill, Bryan MD§; Schlichting, Nicolette MD*; Smith, Natalie MD*; DeMaria, Samuel Jr MD*; Zerillo, Jeron MD*

doi: 10.1213/ANE.0000000000003343
Technology, Computing, and Simulation

This retrospective observational case series conducted at 2 large academic centers over a 4-year period consists of 15 cases of profound hypotension in surgical patients immediately after initiation of the Belmont Fluid Management System for rapid transfusion of blood products. Halting the infusion and administering vasoactive agents led to resolution of hypotension. Repeat transfusion with the Belmont system resulted in repeat hypotension unless counteracted with vasopressors. No etiology was elucidated. This represents the largest documented association of acute hypotensive transfusion reaction with any rapid infusion system in surgical patients.

From the *Mount Sinai Hospital, New York, New York

Hospital for Special Surgery, New York, New York

University of California at San Francisco, San Francisco, California

§Ohio State University Medical Center, Columbus, Ohio.

Published ahead of print 01 February 2018.

Accepted for publication February 1, 2018.

Funding: None.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Joanna Miller, MD, Mount Sinai Hospital, 1 Gustave Levy Pl, New York, NY 10129. Address e-mail to

Copyright © 2018 International Anesthesia Research Society
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