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Updated: Oct 17, 2025

Microfluidics in Assessing Platelet Function
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Massive transfusion in trauma: an evolving paradigm.

Tobias Gauss1, Jean-Denis Moyer1, Pierre Bouzat2

  • 1Unit of Anesthesia and Critical Care, Hôpital Beaujon, DMU PARABOL, APHP Nord - Université de Paris, Paris, France.

Minerva Anestesiologica
|October 12, 2021
PubMed
Summary
This summary is machine-generated.

Massive transfusion protocols are evolving, challenging the traditional definition. A new concept, "time critical transfusion," better reflects modern trauma care strategies and blood product management.

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Area of Science:

  • Trauma resuscitation
  • Hemorrhagic shock management
  • Transfusion medicine

Background:

  • The concept of massive transfusion as a distinct entity in trauma has been widely accepted.
  • However, current evidence suggests a paradigm shift in transfusion strategies.
  • The traditional definition of massive transfusion may no longer be adequate.

Purpose of the Study:

  • To review the evolution of massive transfusion protocols in trauma.
  • To challenge the classic definition and paradigm of massive transfusion.
  • To propose an alternative concept for modern transfusion management.

Main Methods:

  • Review of current literature on transfusion management and bleeding control in trauma.
  • Analysis of evolving strategies including tranexamic acid, blood product ratios, fluid management, and viscoelastic testing.
  • Conceptual re-evaluation of the definition and application of massive transfusion.

Main Results:

  • Current evidence supports an evolving strategy in transfusion management.
  • Key elements include tranexamic acid, optimized blood product ratios, judicious fluid use, and viscoelastic hemostatic assays.
  • These elements collectively form the basis for updated trauma transfusion strategies.

Conclusions:

  • The classic definition of massive transfusion is outdated.
  • The need for massive transfusion may indicate a failure in early management.
  • Time critical transfusion is a more appropriate concept for contemporary trauma care.