OBJECTIVES: To review outcomes of massive transfusion protocol (MTP) activation and determine the impact of MTP implementation on blood bank use. BACKGROUND: MTP has been established to rapidly provide plasma and packed red blood cells in ratios approaching 1 : 1. Due to availability, MTP has been utilised in non-traumatic haemorrhage despite evidence of benefit in this population. Our hospital-wide implementation of MTP was reviewed for propriety, outcomes and effect on blood bank resources. METHODS: Retrospective cohort study of patients receiving transfusion after MTP activation from October 2009 to 2011. Underlying medical conditions and baseline medication use were determined. In-hospital and 24-h mortality were compared with evaluation for confounding by Acute Physiology And Chronic Health Evaluation (APACHE) score and duration of MTP activation. Blood product use before and after MTP implementation was reviewed. RESULTS: MTP activation occurred in 62 trauma and 63 non-trauma patients. Non-trauma patients were older, had more underlying medical conditions and higher APACHE scores compared with trauma patients; 24-h mortality was higher in trauma compared with non-trauma patients (27·4 vs 11·1%, P = 0·02). There was no significant difference of in-hospital mortality. Transfusion ratio did not differ between trauma and non-trauma patients and was not associated with mortality even when MTP activation duration and APACHE score were considered. Hospital-wide blood product use did not change with MTP implementation. CONCLUSIONS: MTP may be successfully used in trauma and non-trauma settings without significantly impacting overall blood product utilisation. Inclusion of non-trauma patients into prospective studies of resuscitation with blood products is warranted to ensure benefit in these patients.
OBJECTIVES: To review outcomes of massive transfusion protocol (MTP) activation and determine the impact of MTP implementation on blood bank use. BACKGROUND:MTP has been established to rapidly provide plasma and packed red blood cells in ratios approaching 1 : 1. Due to availability, MTP has been utilised in non-traumatic haemorrhage despite evidence of benefit in this population. Our hospital-wide implementation of MTP was reviewed for propriety, outcomes and effect on blood bank resources. METHODS: Retrospective cohort study of patients receiving transfusion after MTP activation from October 2009 to 2011. Underlying medical conditions and baseline medication use were determined. In-hospital and 24-h mortality were compared with evaluation for confounding by Acute Physiology And Chronic Health Evaluation (APACHE) score and duration of MTP activation. Blood product use before and after MTP implementation was reviewed. RESULTS:MTP activation occurred in 62 trauma and 63 non-traumapatients. Non-traumapatients were older, had more underlying medical conditions and higher APACHE scores compared with traumapatients; 24-h mortality was higher in trauma compared with non-traumapatients (27·4 vs 11·1%, P = 0·02). There was no significant difference of in-hospital mortality. Transfusion ratio did not differ between trauma and non-traumapatients and was not associated with mortality even when MTP activation duration and APACHE score were considered. Hospital-wide blood product use did not change with MTP implementation. CONCLUSIONS:MTP may be successfully used in trauma and non-trauma settings without significantly impacting overall blood product utilisation. Inclusion of non-traumapatients into prospective studies of resuscitation with blood products is warranted to ensure benefit in these patients.
Authors: Bryan C Morse; Christopher J Dente; Erica I Hodgman; Beth H Shaz; Jeffrey M Nicholas; Amy D Wyrzykowski; Jeffrey P Salomone; Gary A Vercruysse; Grace S Rozycki; David V Feliciano Journal: Am Surg Date: 2011-08 Impact factor: 0.688
Authors: Matthew D Neal; Alyce Marsh; Ryan Marino; Benjamin Kautza; Jay S Raval; Raquel M Forsythe; Gary T Marshall; Jason L Sperry Journal: Arch Surg Date: 2012-06
Authors: Bryan C Morse; Christopher J Dente; Erica I Hodgman; Beth H Shaz; Anne Winkler; Jeffrey M Nicholas; Amy D Wyrzykowski; Grace S Rozycki; David V Feliciano Journal: Am Surg Date: 2012-06 Impact factor: 0.688
Authors: John B Holcomb; Deborah J del Junco; Erin E Fox; Charles E Wade; Mitchell J Cohen; Martin A Schreiber; Louis H Alarcon; Yu Bai; Karen J Brasel; Eileen M Bulger; Bryan A Cotton; Nena Matijevic; Peter Muskat; John G Myers; Herb A Phelan; Christopher E White; Jiajie Zhang; Mohammad H Rahbar Journal: JAMA Surg Date: 2013-02 Impact factor: 14.766
Authors: Lauren M McDaniel; Matthew D Neal; Jason L Sperry; Louis H Alarcon; Raquel M Forsythe; Darrell Triulzi; Andrew B Peitzman; Jay S Raval Journal: J Am Coll Surg Date: 2013-04-06 Impact factor: 6.113
Authors: Kirsten Balvers; Michiel Coppens; Susan van Dieren; Ingeborg H M van Rooyen-Schreurs; Henriëtte J Klinkspoor; Sacha S Zeerleder; Holger M Baumann; J Carel Goslings; Nicole P Juffermans Journal: J Emerg Trauma Shock Date: 2015 Oct-Dec