Any changes in recent massive transfusion practices in a tertiary level institution?
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Date
2017-06-08
Authors
Sinha, Romi
Roxby, David John
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Rights
© 2017 Elsevier.
Rights Holder
Elsevier.
Abstract
Background & objectives
A previous review of transfusion practices in our institution between 1998 and 2008 showed a trend of high ratios of red cells (RC) to plasma (FFP) and platelets to RC towards the later years of review period. The aim of the study was to further evaluate transfusion practices in the form of blood product usage and outcomes following massive transfusion (MT)
Methods
All adult patients with critical bleeding who received a MT (defined as ≥10 units of RC in 24 h) in 2008 and between January 2010 and December 2014 were identified. Blood and blood products transfused, in-hospital mortality, 24 h and 90-day mortality were analysed for the period 2010–2014. Blood and blood product usage, massive transfusion protocol (MTP) activation and use of ROTEM between 2008 and 2014 were compared.
Results
A total of 190 MT including surgical (52.1%), gastro-intestinal bleeding (25.3%), trauma (11.6%) and obstetric haemorrhage (5.8%) episodes were identified between 2010 and 2014. The overall in-hospital mortality was 26.7% with a significant difference in 24 h (p = 0.04) and 90-day mortality (p = 0.02) between diagnostic groups. Comparing 2008 (n = 33) and 2014 (n = 23), there was no significant difference in median RC, FFP and platelet units, cryoprecipitate doses and RC:FFP ratio; however there was an increase in number of patients who used cryoprecipitate (54.5% vs 87%, p = 0.01).
Conclusion
Aligned with haemostatic resuscitation, the trend continues in the form of increased use of plasma and higher RC:FFP transfusion ratios including an increase in number of patients receiving cryoprecipitate.
Description
This manuscript version is made available under the CC-BY-NC-ND 4.0 license
http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 12 month embargo from date of publication (June 2017) in accordance with the publisher’s archiving policy
Keywords
Massive transfusion, Haemostatic resuscitation, Transfusion practice
Citation
Sinha, R., & Roxby, D. (2017). Any changes in recent massive transfusion practices in a tertiary level institution? Transfusion and Apheresis Science, 56(4), 558–562. https://doi.org/10.1016/j.transci.2017.05.013