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Related Concept Videos

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
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Ex Situ Normothermic Machine Perfusion of Donor Livers
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Massive transfusion in The Netherlands.

Tim W H Rijnhout1,2, Femke Noorman3, Annemarije Bek3

  • 1Department of Surgery, Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands twhrijnhout@alrijne.nl.

Emergency Medicine Journal : EMJ
|December 14, 2019
PubMed
Summary
This summary is machine-generated.

Massive transfusion protocols (MTPs) vary significantly among Dutch trauma centers, with different blood product ratios and fibrinogen administration strategies. Annual MTP updates are recommended to align with the latest evidence and guidelines for improved patient outcomes.

Keywords:
bloodemergencymassivemilitaryplateletsprotocolsurgerytranexamic acidtransfusiontrauma

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Area of Science:

  • Trauma Care
  • Hemorrhage Management
  • Transfusion Medicine

Background:

  • Massive transfusion protocols (MTPs) are critical for managing uncontrolled hemorrhage.
  • Dutch transfusion guidelines and advanced trauma life support courses have incorporated MTPs since 2011-2013.
  • This study provides the first survey of MTP practices in Dutch trauma centers.

Purpose of the Study:

  • To compare MTP strategies implemented in Dutch level 1 trauma centers.
  • To assess adherence of these MTPs to international guidelines.
  • To identify variations in MTP components and administration.

Main Methods:

  • A survey and follow-up interview were conducted with representatives from all 11 Dutch level 1 trauma centers and the Ministry of Defence.
  • MTPs were collected and analyzed for transfusion ratios, use of tranexamic acid, fibrinogen, and anticoagulants.
  • Protocols were compared against national and international guidelines.

Main Results:

  • All 11 trauma centers participated, revealing diverse transfusion ratios (e.g., 3:3:1, 5:5:1, 5:3:1 RBCs/plasma/platelets).
  • Tranexamic acid was universally used, with eight centers administering an additional dose.
  • Fibrinogen administration varied (direct, persistent bleeding, Clauss, or ROTEM-based), and anticoagulant use was ambiguous.

Conclusions:

  • Significant MTP discrepancies exist between Dutch trauma centers and guidelines, likely due to variations in blood component preparation and interpretation of the '1:1:1' ratio.
  • Annual MTP updates are recommended to incorporate the latest guidelines.
  • Continuous evaluation of evidence supporting treatments within MTPs is crucial.