Massive transfusion: an evidence-based review of recent developments

Area of Science:

• Trauma and Emergency Medicine
• Hematology
• Critical Care

Background:

• Massive transfusion protocols (MTPs) and ratio-based transfusion are critical in managing severe hemorrhage.
• Hemostatic resuscitation and adjuncts like recombinant factor VIIa and tranexamic acid are areas of active research and debate.

Purpose of the Study:

• To review advancements in massive transfusion research over the past five years.
• To analyze the evidence for component therapy and adjuncts in massive transfusion.
• To provide recommendations for resuscitation agents and goal-directed therapy for coagulopathy.

Main Methods:

• Literature review of massive transfusion research from the last 5 years.
• Analysis of evidence supporting hemostatic resuscitation, tranexamic acid, and recombinant factor VIIa.
• Evaluation of goal-directed therapy for coagulopathy.

Main Results:

• Significant developments in MTP implementation and hemostatic resuscitation strategies.
• Growing evidence supports the use of tranexamic acid and recombinant factor VIIa in specific contexts.
• New methods for goal-directed therapy are emerging for managing coagulopathy.

Conclusions:

• Massive transfusion research has advanced significantly, focusing on protocol optimization and evidence-based adjuncts.
• Component therapy and adjuncts require careful consideration based on available evidence.
• Goal-directed therapy offers promising approaches for managing coagulopathy in massive transfusion scenarios.