Massive transfusion practices around the globe and a suggestion for a common massive transfusion protocol

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Hemorrhage Control

Background:

• Massive transfusion (MT) involves administering 10-100+ units of red blood cells (RBC) in <24 hours for severe injuries.
• Rapid RBC administration with plasma and platelets is often disorganized, necessitating standardized protocols.
• A common protocol can improve patient care and facilitate collaborative research in trauma resuscitation.

Purpose of the Study:

• To identify and evaluate existing massive transfusion protocols (MTPs) used by trauma organizations and centers.
• To assess the goals and ease of use of current MTPs.

Main Methods:

• Surveyed trauma organizations and trauma centers for existing MTPs.
• Evaluated the objectives and usability of identified protocols.

Main Results:

• MTPs are utilized by a limited number of large, organized trauma centers.
• Most existing protocols focus on treating pre-existing or ongoing coagulopathy.

Conclusions:

• Preventing coagulopathy is more effective than treating it.
• Simple 1:1:1 RBC:plasma:platelet ratios offer ease of use and improved outcomes.
• Standardized MTPs can standardize multicenter research and use RBC administration as a surrogate for blood loss.