Massive Transfusion Protocols Vary Among U.S. Hospitals

Over the past several years, clinical studies have shown that blood transfused early and quickly can reduce mortality in severe trauma patients or those with severe hemorrhage. This has led to the widespread use of massive transfusion protocols (MTPs). Results from a recent online survey answered by 191 surgeons from 125 institutions revealed that MTPs vary among United States hospitals. Almost all institutions (123/125) that participated in the survey have MTPs, but 54% implemented their protocols within the past 5 years.  About half of the institutions include 5-10 units of RBCs in the first MTP cooler, and the remaining institutions include fewer than 5 units in the first cooler.  Plasma is present in 87% of the coolers, and 58% contain platelets.  About two-thirds of the institutions use tranexamic acid, while about 25% still use recombinant activated Factor VII.  Only 7% of participating institutions use a validated scoring system, such as the Assessment of Blood Consumption, to determine when to activate MTPs.  Future studies are needed to optimize and standardize MTPs.

Reference:

1. Etchill E, Sperry J, Zuckerbraun B, Alarcon L, Brown J, Schuster K, Kaplan L, Piper G, Peitzman A, Neal MD. The confusion continues: results from an American Association for the Surgery of Trauma survey on massive transfusion practices among United States trauma centers. Transfusion 2016;56: 2478-86.

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