State of the art: massive transfusion

Area of Science:

• Emergency Medicine
• Critical Care
• Hemorrhage Management

Background:

• Massive transfusion protocols (MTPs) are crucial for managing severe hemorrhage in trauma patients.
• Recent research is expanding the application and understanding of MTPs to non-trauma populations.

Purpose of the Study:

• To review recent advancements in resuscitation strategies for trauma and non-trauma patients experiencing hemorrhagic shock.
• To identify key developments in massive transfusion (MT) literature from 2012 to present.

Main Methods:

• Systematic review of Medline and PubMed databases for articles on 'massive transfusion' (MT) published from 2012 to the present.
• Exclusion of non-English and pediatric articles.
• Focused review on articles relevant to MT practices and outcomes.

Main Results:

• Increased focus on non-trauma patients with massive hemorrhage and the role of acute traumatic coagulopathy.
• Evaluation of thromboelastography (TEG) and MTP impact on blood product waste and delivery efficiency.
• Development of new MT prediction tools and studies like PROMMTT.

Conclusions:

• Recent developments aim to improve understanding and management of non-traumatic hemorrhage.
• There is a need to re-evaluate MT definitions and identify new research areas.
• Emerging questions will shape future research in massive transfusion.