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Balvers K, Coppens M, van Dieren S, et al. Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste. J Emerg Trauma Shock. 2015;8(4):199-204doi: 10.4103/0974-2700.166597.
Balvers, K., Coppens, M., van Dieren, S., van Rooyen-Schreurs, I. H., Klinkspoor, H. J., Zeerleder, S. S., Baumann, H. M., Goslings, J. C., & Juffermans, N. P. (2015). Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste. Journal of emergencies, trauma, and shock, 8(4), 199-204. https://doi.org/10.4103/0974-2700.166597
Balvers, Kirsten, et al. "Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste." Journal of emergencies, trauma, and shock vol. 8,4 (2015): 199-204. doi: https://doi.org/10.4103/0974-2700.166597
Balvers K, Coppens M, van Dieren S, van Rooyen-Schreurs IH, Klinkspoor HJ, Zeerleder SS, Baumann HM, Goslings JC, Juffermans NP. Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste. J Emerg Trauma Shock. 2015 Oct-Dec;8(4):199-204. doi: 10.4103/0974-2700.166597. PMID: 26604525; PMCID: PMC4626936.
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J Emerg Trauma Shock. 2015 Oct-Dec;8(4):199-204. doi: 10.4103/0974-2700.166597.

Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste.

Journal of emergencies, trauma, and shock

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

Affiliations

  1. Trauma Unit, Department of Surgery, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands ; Department of Intensive Care Medicine, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  2. Department of Vascular Medicine, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  3. Clinical Research Unit, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  4. Laboratory of Hematology, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  5. Laboratory of Clinical Chemistry, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  6. Clinical Research Unit, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands ; Department of Immunopathology, Sanquin Research, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  7. Department of Anesthesiology, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  8. Trauma Unit, Department of Surgery, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.
  9. Department of Intensive Care Medicine, Academic Medical Center, Bijlmer, Amsterdam, The Netherlands.

PMID: 26604525 PMCID: PMC4626936 DOI: 10.4103/0974-2700.166597

Abstract

BACKGROUND: Massive transfusion protocols (MTPs) are increasingly used in the transfusion practice and are developed to provide the standardized and early delivery of blood products and procoagulant agents and to supply the transfusion of blood products in a well-balanced ratio.

AIM: The aim of this study was to investigate the effect of a hospital-wide introduction of an MTP on blood product ratio and a waste of blood products.

MATERIALS AND METHODS: Retrospective analysis was performed to compare the transfusion practice in massive bleeding patients before and after the introduction of an MTP and between the use of an MTP and transfusion off-protocol. Massive bleeding was defined as an administration of ≥5 units of red blood cells (RBCs) within 12 h.

RESULTS: Of 547 massively transfused patients, 192 patients were included in the pre-MTP period and 355 patients in the MTP period. The ratio of RBC to fresh frozen plasma (FFP) and the platelets transfused shifted significantly toward 1:1:1 in the MTP period (P = 0.012). This was mainly caused by a shift in RBC: FFP ratio (P = 0.014). An increase in the waste of blood products was observed, most notably FFPs (P = 0.026). Extending the storage time after thawing reduced the waste of FFPs from 11% to 4%.

CONCLUSION: Hospital-wide introduction of an MTP is an adequate way to achieve a well-balanced transfusion ratio of 1:1:1. This comes at the cost of an increase in the waste of FFPs, which is lowered after extending the duration of storage time after thawing.

Keywords: Bleeding; protocol; transfusion

References

  1. J Trauma. 2011 Jan;70(1):81-8; discussion 88-9 - PubMed
  2. Obstet Gynecol. 2010 Dec;116(6):1302-9 - PubMed
  3. J Am Coll Surg. 2013 Jun;216(6):1103-9 - PubMed
  4. J Trauma. 1995 Feb;38(2):185-93 - PubMed
  5. Scand J Gastroenterol. 2014 Apr;49(4):458-64 - PubMed
  6. Transfusion. 2013 Mar;53(3):645-50 - PubMed
  7. J Trauma. 2008 May;64(5):1177-82; discussion 1182-3 - PubMed
  8. Transfus Apher Sci. 2014 Apr;50(2):274-80 - PubMed
  9. Am J Surg. 2009 May;197(5):565-70; discussion 570 - PubMed
  10. J Trauma. 2008 Nov;65(5):986-93 - PubMed
  11. Can J Surg. 2013 Oct;56(5):E128-34 - PubMed
  12. JAMA Surg. 2013 Feb;148(2):127-36 - PubMed
  13. Emerg Med Australas. 2014 Jun;26(3):223-8 - PubMed
  14. J Trauma Acute Care Surg. 2014 May;76(5):1243-50 - PubMed
  15. J Trauma. 2009 Feb;66(2):346-52 - PubMed
  16. JAMA. 2015 Feb 3;313(5):471-82 - PubMed
  17. Am Surg. 2012 Jun;78(6):679-84 - PubMed
  18. World J Surg. 2010 Jan;34(1):158-63 - PubMed
  19. J Am Coll Surg. 2009 Aug;209(2):198-205 - PubMed
  20. Am Surg. 2011 Aug;77(8):1043-9 - PubMed
  21. Arch Surg. 2008 Jul;143(7):686-90; discussion 690-1 - PubMed
  22. Injury. 2013 May;44(5):587-92 - PubMed
  23. JAMA Surg. 2013 Sep;148(9):834-40 - PubMed
  24. J Trauma. 2009 Jun;66(6):1616-24 - PubMed
  25. Transfusion. 2010 Jul;50(7):1545-51 - PubMed
  26. Transfus Med. 2014 Jun;24(3):162-8 - PubMed

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