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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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Defining ultra-massive transfusion through a systematic review.

Courtney H Meyer1, Neal Mody Bailey2, Sharon L Leslie3

  • 1Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA; Emory University Rollins School of Public Health, Atlanta, GA, USA.

American Journal of Surgery
|November 4, 2024
PubMed
Summary
This summary is machine-generated.

Ultra-massive transfusion (UMT) lacks a standard definition. This review suggests defining UMT as ≥20 red blood cell units in 24 hours to improve trauma care and research.

Keywords:
Blood transfusionConsensus definitionSystematic reviewTrauma patientUltra-massive

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Area of Science:

  • Trauma resuscitation
  • Hemorrhagic shock management
  • Blood product utilization

Background:

  • Ultra-massive transfusion (UMT) is used for trauma patients in hemorrhagic shock.
  • No standardized definition for UMT currently exists.
  • This systematic review aimed to establish a consensus definition for UMT.

Purpose of the Study:

  • To determine a consensus definition for ultra-massive transfusion (UMT).
  • To identify parameters associated with increased mortality in patients receiving UMT.

Main Methods:

  • Systematic review of studies from 1979 to 2022.
  • Screening of articles based on PICO questions and PRISMA guidelines.
  • Data extraction from eligible studies defining UMT and outcomes.

Main Results:

  • Eight studies were included for data extraction.
  • Only two studies proposed a consensus definition: ≥20 units of red blood cells within 24 hours.
  • Lower blood pressure, pulse, Glasgow Coma Score, higher Injury Severity Score, and resuscitative thoracotomy correlated with increased mortality.

Conclusions:

  • The lack of a standardized UMT definition presents clinical, research, and ethical challenges.
  • Standardizing UMT as ≥20 red blood cell units within 24 hours is feasible.
  • This standardization can enhance clinical care, research consistency, and ethical considerations in trauma management.