Efficacy of a massive transfusion protocol for hemorrhagic trauma resuscitation

Lim, George; Harper-Kirksey, Katrina; Parekh, Ram; Manini, Alex F.

doi:10.1016/j.ajem.2017.11.060

Cited by 26 publications

(18 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Blood transfusion is a common therapy in hospitals, particularly for serious trauma and major surgeries [ 20 , 21 ]. However, the prognosis can differ even if the same blood transfusion strategy is applied.…”

Section: Discussionmentioning

confidence: 99%

Association between recipient survival and blood donor age after blood transfusion in a surgery intensive care unit: a multicenter randomized controlled trial study protocol

Zeng

Liao

et al. 2020

Trials

View full text Add to dashboard Cite

Background Blood from younger individuals has been shown to improve physiological function in recipients in laboratory research, and many proteins from human peripheral blood show antisenescence capabilities. Thus, researchers have questioned whether blood from young donors is superior to blood from older donors. Blood transfusion is a key supportive therapy for trauma patients, and recent studies have reported the influence of blood donor age on recipient patient prognosis. Although some retrospective results found that blood from young donors improves survival, no influence of blood donor age was observed on outcomes in other study groups. The reasons for this discrepancy are complicated, but the fact that data were not obtained from randomized controlled trial (RCT) data should be considered. The current protocol and analysis method provide a feasible RCT design to evaluate the prognosis of severely ill surgery patients who were transfused with blood products from blood donors of different ages. Methods The current study is a pragmatic multicenter RCT (open, parallel-group, non-masked, superiority trial). Recruited surgery intensive care unit patients will be randomized into three groups and transfused with blood products from male donors of different ages (< 25, 25–45, and > 45 years). Survival time will be measured within 28 days. The survival characteristics, possible interaction between variables, and potential factors associated with death will be analyzed by Kaplan–Meier analysis, two-way ANOVA, and Cox proportional hazards model, respectively. Trial registration ChiCTR: ChiCTR190002. Registered on 22 March 2019. http://www.chictr.org.cn/showproj.aspx?proj=36867 .

show abstract

Section: Discussionmentioning

confidence: 99%

Association between recipient survival and blood donor age after blood transfusion in a surgery intensive care unit: a multicenter randomized controlled trial study protocol

Zeng

Liao

et al. 2020

Trials

View full text Add to dashboard Cite

show abstract

“…MTPs have been shown to improve outcomes in hemorrhaging trauma patients. 7,13,14,16 This Level I trauma center has successfully used an MTP since 2007 with specialized TNCs administering blood products during initial resuscitation in the trauma bay. Since 2015, the TNCs have assumed responsibility for administering the MTP intraoperatively, focusing exclusively on maintaining appropriate blood product ratios.…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of selected goal ratios, adherence to an MTP itself has been shown to improve patient outcomes. 3,7,14,16 Cotton et al 18 found that a predefined protocol reduced multiorgan failure, infectious complications, and increased ventilator-free days.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Resuscitation by Specialized Trauma Nurse Clinicians Improves Adherence to Massive Transfusion Protocol

May

Harrell

Bell

et al. 2020

The American Surgeon™

View full text Add to dashboard Cite

A massive transfusion protocol (MTP) was implemented at a Level I trauma center in 2007 for patients with massive blood loss. A goal ratio of plasma to pheresed platelets to packed red blood cells (PRBCs) of 1:1:1 was established. From 2007 to 2014, trauma nurse clinicians (TNCs) administered the MTP during initial resuscitation and anesthesia personnel administered the MTP intraoperatively. In 2015, TNCs began administering the MTP intraoperatively. This study evaluates intraoperative blood product ratios and crystalloid volume administered by anesthesia personnel or TNCs. A retrospective review of trauma registry patients requiring MTP from 2007 to 2017 was performed. Patient data were stratified according to MTP administration by either anesthesia personnel (2007–2015) or TNCs (2015–2017). Ninety-seven patients were included with 54 anesthesia patients and 44 TNC patients. Patients undergoing resuscitation by MTP administered by TNCs received less median crystalloid (3000 mL vs 1500 mL, P < 0.001). The ratio of plasma:PRBC (0.75 vs 0.93, P = 0.027) and platelets:PRBC (0.75 vs 1.04, P = 0.003) was found to be significantly closer to 1:1 for TNC patients. MTP intraoperative blood product administration by TNCs reduced the amount of infused crystalloid and improved adherence to MTP in achieving a 1:1:1 ratio of blood products.

show abstract

“…A massive transfusion protocol (MTP) is required for efficient massive transfusion, as it aims to rapidly and effectively deliver the blood products that are necessary for trauma resuscitation. Many trauma centers have implemented MTPs to deliver blood products, resulting in improved patient outcomes and mortality [7][8][9]. Accordingly, we also introduced a MTP in February 2018 and have applied it in the context of massive transfusions in severe trauma patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center

Sun¹,

Lee²,

Park³

et al. 2020

J Trauma Inj

View full text Add to dashboard Cite

This study was conducted to investigate whether rapid and efficient administration of blood products was achieved and whether clinical outcomes were improved by applying a massive transfusion protocol (MTP). methods: From January 2016 to September 2019, the medical records of trauma patients who received at least 10 units of packed red blood cells (PRBC) at Pusan National University Hospital (level I trauma center) were retrospectively reviewed. The patients treated from January 2016 to January 2018 were designated as the non-MTP group, and those treated from February 2018 to September 2019 were designated as the MTP group. results: During the study period, 370 patients received massive transfusions. The non-MTP and MTP groups comprised 84 and 55 patients, respectively. No significant between-group differences were found in the units of PRBC (23.2 vs. 25.3, respectively; p=0.46), fresh frozen plasma (FFP) (21.1 vs. 24.4, respectively; p=0.40), and platelets (PLT) (15.4 vs. 17.0, respectively; p=0.54) administered in the first 24 hours. No statistically significant differences between the non-MTP and MTP groups were found in the FFP-to-PRBC ratio (0.9 vs. 0.94, respectively; p=0.44) and or the PLT-to-PRBC ratio (0.72 vs. 0.72, respectively; p=0.21). However, the total number of cryoprecipitate units was significantly higher in the MTP group than in the non-MTP group (7.4 vs. 15.3 units, respectively; p=0.003) and the ratio of cryoprecipitate to PRBC in the MTP group was significantly higher than in the non-MTP group (0.31 vs. 0.62, respectively; p=0.021). The time to transfusion was significantly reduced after MTP implementation (41.0 vs. 14.9 minutes, respectively; p=0.003). Conclusions: Although no significant differences were found in the clinical outcomes of patients who had undergone severe trauma, rapid and balanced transfusion was achieved after implementing the MTP.

show abstract

Efficacy of a massive transfusion protocol for hemorrhagic trauma resuscitation

Cited by 26 publications

References 33 publications

Association between recipient survival and blood donor age after blood transfusion in a surgery intensive care unit: a multicenter randomized controlled trial study protocol

Association between recipient survival and blood donor age after blood transfusion in a surgery intensive care unit: a multicenter randomized controlled trial study protocol

Intraoperative Resuscitation by Specialized Trauma Nurse Clinicians Improves Adherence to Massive Transfusion Protocol

Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center

Contact Info

Product

Resources

About