Massive Transfusion Protocol 2020

[Pages:9]Surgical Critical

MASSIVE TRANSFUSION FOR COAGULOPATHY AND HEMORRHAGIC SHOCK

Evidence Based Medicine Guideline

Authors: David Motola, MD; Amanda Giancarelli, PharmD; Brandon Hobbs, PharmD; Dorothy Sparks, MD Editors: Michael L. Cheatham, MD; Chadwick P. Smith, MD Approved: 05/25/2010 Revised 08/01/2012, 11/2/2017 Last revision date: 5/7/2020

SUMMARY Exsanguination is a leading cause of early death following traumatic injury. Protocol-driven transfusion strategies that approach a 1:1:1 [packed red blood cell (PRBC), fresh frozen plasma (FFP), and platelet (PLT)] ratio in patients who require massive transfusion improve patient survival, reduce hospital / intensive care unit (ICU) length of stay, decrease ventilator days, and reduce patient care costs.

RECOMMENDATIONS

? Level 1 Recombinant factor VIIa may reduce blood product administration, but does not improve survival.

? Level 2 Administer blood products in a ratio of 1:1:1 (PRBC:FFP:PLT). In patients requiring massive transfusion of blood products, minimize crystalloid resuscitation to prevent dilutional coagulopathy. Platelet transfusions are indicated in the following situations: Neurosurgical procedures with PLT count ................
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