Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center
Purpose This study was conducted to investigate whether rapid and efficient administration of blood products was achieved and whether clinical outcomes were improved by applying a massive transfusion protocol (MTP). Methods From January 2016 to September 2019, the medical records of trauma patients...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Traumatology
2020-06-01
|
| Series: | Journal of Trauma and Injury |
| Subjects: | |
| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-2020-022.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832543985914085376 |
|---|---|
| author | Hyun Woo Sun Sang Bong Lee Sung Jin Park Chan Ik Park Jae Hun Kim |
| author_facet | Hyun Woo Sun Sang Bong Lee Sung Jin Park Chan Ik Park Jae Hun Kim |
| author_sort | Hyun Woo Sun |
| collection | DOAJ |
| description | Purpose This study was conducted to investigate whether rapid and efficient administration of blood products was achieved and whether clinical outcomes were improved by applying a massive transfusion protocol (MTP). Methods From January 2016 to September 2019, the medical records of trauma patients who received at least 10 units of packed red blood cells (PRBC) at Pusan National University Hospital (level I trauma center) were retrospectively reviewed. The patients treated from January 2016 to January 2018 were designated as the non-MTP group, and those treated from February 2018 to September 2019 were designated as the MTP group. Results During the study period, 370 patients received massive transfusions. The non-MTP and MTP groups comprised 84 and 55 patients, respectively. No significant between-group differences were found in the units of PRBC (23.2 vs. 25.3, respectively; p=0.46), fresh frozen plasma (FFP) (21.1 vs. 24.4, respectively; p=0.40), and platelets (PLT) (15.4 vs. 17.0, respectively; p=0.54) administered in the first 24 hours. No statistically significant differences between the non-MTP and MTP groups were found in the FFP-to-PRBC ratio (0.9 vs. 0.94, respectively; p=0.44) and or the PLT-to-PRBC ratio (0.72 vs. 0.72, respectively; p=0.21). However, the total number of cryoprecipitate units was significantly higher in the MTP group than in the non-MTP group (7.4 vs. 15.3 units, respectively; p=0.003) and the ratio of cryoprecipitate to PRBC in the MTP group was significantly higher than in the non-MTP group (0.31 vs. 0.62, respectively; p=0.021). The time to transfusion was significantly reduced after MTP implementation (41.0 vs. 14.9 minutes, respectively; p=0.003). Conclusions Although no significant differences were found in the clinical outcomes of patients who had undergone severe trauma, rapid and balanced transfusion was achieved after implementing the MTP. |
| format | Article |
| id | doaj-art-56f0bf5e10144392a9c664945e44a519 |
| institution | Kabale University |
| issn | 1738-8767 2287-1683 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-56f0bf5e10144392a9c664945e44a5192025-02-03T11:12:22ZengKorean Society of TraumatologyJournal of Trauma and Injury1738-87672287-16832020-06-01332748010.20408/jti.2020.0221020Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma CenterHyun Woo Sun0Sang Bong Lee1Sung Jin Park2Chan Ik Park3Jae Hun Kim4 Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, Korea Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, Korea Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, Korea Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, Korea Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, KoreaPurpose This study was conducted to investigate whether rapid and efficient administration of blood products was achieved and whether clinical outcomes were improved by applying a massive transfusion protocol (MTP). Methods From January 2016 to September 2019, the medical records of trauma patients who received at least 10 units of packed red blood cells (PRBC) at Pusan National University Hospital (level I trauma center) were retrospectively reviewed. The patients treated from January 2016 to January 2018 were designated as the non-MTP group, and those treated from February 2018 to September 2019 were designated as the MTP group. Results During the study period, 370 patients received massive transfusions. The non-MTP and MTP groups comprised 84 and 55 patients, respectively. No significant between-group differences were found in the units of PRBC (23.2 vs. 25.3, respectively; p=0.46), fresh frozen plasma (FFP) (21.1 vs. 24.4, respectively; p=0.40), and platelets (PLT) (15.4 vs. 17.0, respectively; p=0.54) administered in the first 24 hours. No statistically significant differences between the non-MTP and MTP groups were found in the FFP-to-PRBC ratio (0.9 vs. 0.94, respectively; p=0.44) and or the PLT-to-PRBC ratio (0.72 vs. 0.72, respectively; p=0.21). However, the total number of cryoprecipitate units was significantly higher in the MTP group than in the non-MTP group (7.4 vs. 15.3 units, respectively; p=0.003) and the ratio of cryoprecipitate to PRBC in the MTP group was significantly higher than in the non-MTP group (0.31 vs. 0.62, respectively; p=0.021). The time to transfusion was significantly reduced after MTP implementation (41.0 vs. 14.9 minutes, respectively; p=0.003). Conclusions Although no significant differences were found in the clinical outcomes of patients who had undergone severe trauma, rapid and balanced transfusion was achieved after implementing the MTP.http://www.jtraumainj.org/upload/pdf/jti-2020-022.pdfblood transfusiontrauma centersretrospective studies |
| spellingShingle | Hyun Woo Sun Sang Bong Lee Sung Jin Park Chan Ik Park Jae Hun Kim Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center Journal of Trauma and Injury blood transfusion trauma centers retrospective studies |
| title | Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center |
| title_full | Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center |
| title_fullStr | Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center |
| title_full_unstemmed | Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center |
| title_short | Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center |
| title_sort | effects of massive transfusion protocol implementation in trauma patients at a level i trauma center |
| topic | blood transfusion trauma centers retrospective studies |
| url | http://www.jtraumainj.org/upload/pdf/jti-2020-022.pdf |
| work_keys_str_mv | AT hyunwoosun effectsofmassivetransfusionprotocolimplementationintraumapatientsatalevelitraumacenter AT sangbonglee effectsofmassivetransfusionprotocolimplementationintraumapatientsatalevelitraumacenter AT sungjinpark effectsofmassivetransfusionprotocolimplementationintraumapatientsatalevelitraumacenter AT chanikpark effectsofmassivetransfusionprotocolimplementationintraumapatientsatalevelitraumacenter AT jaehunkim effectsofmassivetransfusionprotocolimplementationintraumapatientsatalevelitraumacenter |