International assessment of massive transfusion protocol contents and indications for activation

Reggie R. Thomasson, Mark H. Yazer, James D. Gorham, MTP Use Study Investigators, on behalf of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative, Romi Sinha

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

BACKGROUND: Massive transfusion protocols (MTPs) provide blood products rapidly and in fixed amounts. MTPs are commonly used in trauma but may also be used in other clinical settings, although evidence to support fixed-ratio resuscitation in nontraumatic hemorrhage is lacking. The goals of this study were to describe the types and contents of available MTPs and the clinical indications for MTP activation. METHODS: A survey was distributed to 353 transfusion medicine specialists to assess the types and contents of available MTPs. Survey participants were invited to provide the clinical indications for consecutive adult and pediatric MTP activations for at least 6 months during 2015 to 2017. RESULTS: There were 125 completed surveys (35% response rate) including three from children's specialty hospitals. Most hospitals that treated adult patients (90/122, 74%) utilized only one MTP for all adult bleeding emergencies, while one hospital had no MTP. Of the 31 hospitals that provided more than one adult MTP, 20 provided MTPs specific for obstetric bleeding cases. Of these, 50% (10/20) included at least one pool of cryoprecipitate or fibrinogen concentrate in the first MTP round, compared with 14% (13/90) of the hospitals with one MTP (p = 0.0012). Fifty-seven hospitals provided the clinical indication for 4176 adult and 155 pediatric MTP activations. Although trauma was the single most common indication, the majority of adult (58%) and pediatric (65%) activations were for nontrauma indications. CONCLUSIONS: The majority of hospitals use a single MTP to manage massive hemorrhage. The majority of MTP activations were for nontrauma indications.

Original languageEnglish
Pages (from-to)1637-1643
Number of pages7
JournalTRANSFUSION
Volume59
Issue number5
Early online date5 Feb 2019
DOIs
Publication statusPublished - May 2019

Keywords

  • massive transfusion protocol
  • international assessment
  • contents and indications for activation

Fingerprint Dive into the research topics of 'International assessment of massive transfusion protocol contents and indications for activation'. Together they form a unique fingerprint.

Cite this