Massive transfusion in trauma: blood product ratios should be measured at 6 hours

• Published in: ANZ journal of surgery 2012-03, Vol.82 (3), p.161-167
• Main Authors: Sisak, Krisztian, Soeyland, Kathleen, McLeod, Monique, Jansen, Melanie, Enninghorst, Natalie, Martin, Andrew, Balogh, Zsolt J.
• Format: Article
• Language: English
• Subjects: Abbreviated Injury Scale; Adult; blood product ratio; Blood transfusions; Clinical Protocols; component therapy; Erythrocyte Transfusion - methods; Factor VIII - therapeutic use; Female; Fibrinogen - therapeutic use; Hemorrhage; Humans; Injury Severity Score; Length of Stay - statistics & numerical data; Male; massive transfusion protocol; Middle Aged; Plasma; Platelet Transfusion - methods; Protocol; Regression Analysis; Retrospective Studies; shock; Shock, Hemorrhagic - etiology; Shock, Hemorrhagic - mortality; Shock, Hemorrhagic - therapy; Time Factors; trauma; Trauma care; Treatment Outcome; Wounds and Injuries - complications; Wounds and Injuries - mortality
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/j.1445-2197.2011.05967.x

Background:  Most potentially preventable haemorrhagic deaths occur within 6 h of injury. Conventionally, blood component therapy delivery is measured by 24‐h cumulative totals and ratios. The study aim was to examine the effect of a massive transfusion protocol (MTP) on early (6 h) balanced component therapy. Methods:  An 88‐month retrospective clinical study at a level 1 trauma centre was undertaken, examining consecutive trauma patients receiving ≥10 units of packed red blood cells (PRBCs) within 24 h, before (pre‐MTP) and after implementation of MTP. Demographic data, injury severity score (ISS), abbreviated injury scale (AIS), shock parameters, coagulation profile, the need for surgical intervention (