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Application of massive transfusion protocol is associated with a low incidence of coagulopathy and mortality rate
Citation
Khalafallah, A and Al-Barzan, AM and Ganguly, A and Bates, G and Gavin, F and Ahuja, KDK and Seaton, D and Brain, T, Application of massive transfusion protocol is associated with a low incidence of coagulopathy and mortality rate, Journal of Blood Disorders and Transfusion, 3, (3) pp. 1-5. ISSN 2155-9864 (2012) [Refereed Article]
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Copyright Statement
Copyright 2012 Khalafallah A, et al. Licenced under Creative Commons Attribution 3.0 http://creativecommons.org/licenses/by-nc/3.0/us/
DOI: doi:10.4172/2155-9864.1000123
Abstract
Background: Massive haemorrhage and subsequent Massive Transfusion (MT) are associated with
serious, often fatal complications including intractable Disseminated Intravascular Coagulation (DIC). Historically
undesirable outcomes demonstrate the need to improve the management approach of MT. It is clear that
evidence-based guidelines and protocols should be developed with the aim of improving MT-outcome.
Methods: We implemented an evidence-based MT-Protocol (MTP) in 2007 and studied all patients (105)
from Jan 2008 to Jan 2011 who required MT and were treated with the MTP at our institution. The MTP includes
two phases and incorporates a fixed volume of Fresh Frozen Plasma (FFP), cryoprecipitate and platelets in
addition to Packed Red Blood Cells (PRBC).
Results: The median age of patients was 57 years (range, 18-86). The male to female ratio was 74:31.
Median Hb was 90 g/L (range, 44-110) and platelet count was 190/nl (range, 34-817). Thirteen patients
developed mild DIC; 22 moderate DIC and one severe DIC. D-dimer showed average increase of 7.9 mg/L with
a range between 0.6-35 mg/L (Normal <0.5). Average INR was 1.97, (range, 1.2-7.2), while average APTT was
36 seconds (range, 22-88s). The mortality rate was 11.4% (12/105) and these were mainly related to underlying
trauma rather than DIC with the exception of 1 patient. The average number of transfused PRBC was 15 units
(range, 6-42); cryoprecipitate, 20(range, 10-60); platelets, 2(range, 1-7) and FFP, 8(range, 2-20).
Conclusion: Despite serious bleeding secondary to trauma or surgery, the implementation of MTP seems
to have reduced the occurrence of severe DIC and was associated with a relatively low mortality-rate. Further
studies to confirm these findings are warranted.
Item Details
| Item Type: | Refereed Article |
|---|---|
| Keywords: | Massive transfusion protocol; Massive haemorrhage; Trauma; Surgery; Coagulopathy; Outcome |
| Research Division: | Medical and Health Sciences |
| Research Group: | Cardiorespiratory Medicine and Haematology |
| Research Field: | Haematology |
| Objective Division: | Health |
| Objective Group: | Clinical Health (Organs, Diseases and Abnormal Conditions) |
| Objective Field: | Blood Disorders |
| Author: | Khalafallah, A (Professor Alhossain Khalafallah) |
| Author: | Al-Barzan, AM (Dr Abdul Majeed) |
| Author: | Bates, G (Mr Gerald Bates) |
| Author: | Ahuja, KDK (Dr Kiran Ahuja) |
| ID Code: | 80058 |
| Year Published: | 2012 |
| Deposited By: | Health Sciences A |
| Deposited On: | 2012-10-19 |
| Last Modified: | 2017-05-29 |
| Downloads: | 286 View Download Statistics |
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