Narrative Review: Is There a Transfusion Cutoff Value After Which Nonsurvivability Is Inevitable in Trauma Patients Receiving Ultramassive Transfusion?

被引:5
|
作者
Kim, Jennie S. S. [1 ]
Casem, Christleen F. F. [2 ]
Baral, Erika [3 ]
Inaba, Kenji [1 ]
Kuza, Catherine M. M. [3 ]
机构
[1] Univ Southern Calif Trauma & Acute Care Surg, Dept Surg, Los Angeles, CA USA
[2] Univ Calif San Francisco East Bay Surg, Dept Surg, Oakland, CA USA
[3] Univ Southern Calif, Dept Anesthesiol, Keck Sch Med, 1450 San Pablo St,Suite 3600, Los Angeles, CA 90033 USA
来源
ANESTHESIA AND ANALGESIA | 2023年 / 137卷 / 02期
关键词
MASSIVE BLOOD-TRANSFUSION; EXCEEDING; 50; UNITS; SURVIVAL; PROTOCOL; MORTALITY; VOLUMES; QUALITY; PLASMA; CELLS;
D O I
10.1213/ANE.0000000000006504
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The institution of massive transfusion protocols (MTPs) has improved the timely delivery of large quantities of blood products and improves patient outcomes. In recent years, the cost of blood products has increased, compounded by significant blood product shortages. There is practical need for identification of a transfusion volume in trauma patients that is associated with increased mortality, or a threshold after which additional transfusion is futile and associated with nonsurvivability. This transfusion threshold is often described in the setting of an ultramassive transfusion (UMT). There are few studies defining what constitutes amount or outcomes associated with such large volume transfusion. The purpose of this narrative review is to provide an analysis of existing literature examining the effects of UMT on outcomes including survival in adult trauma patients and to determine whether there is a threshold transfusion limit after which mortality is inevitable. Fourteen studies were included in this review. The data examining the utility of UMT in trauma are of poor quality, and with the variability inherent in trauma patients, and the surgeons caring for them, no universally accepted cutoff for transfusion exists. Not surprisingly, there is a trend toward increasing mortality with increasing transfusions. The decision to continue transfusing is multifactorial and must be individualized, taking into consideration patient characteristics, institution factors, blood bank supply, and most importantly, constant reevaluation of the need for ongoing transfusion rather than blind continuous transfusion until the heart stops.
引用
收藏
页码:354 / 364
页数:11
相关论文
共 50 条
  • [1] Survival after ultramassive transfusion: a review of 1360 cases
    Dzik, Walter Sunny
    Ziman, Alyssa
    Cohen, Claudia
    Pai, Menaka
    Lozano, Miguel
    Kaufman, Richard M.
    Delaney, Meghan
    Selleng, Kathleen
    Murphy, Michael F.
    Hervig, Tor
    Yazer, Mark
    TRANSFUSION, 2016, 56 (03) : 558 - 563
  • [2] Transfusion Approaches and Mortality in Trauma Patients: A Narrative Review
    Fries, Dietmar
    Innerhofer, Petra
    Spahn, Donat R.
    SEMINARS IN THROMBOSIS AND HEMOSTASIS, 2017, 43 (07): : 759 - 771
  • [3] Hypocalcemia in trauma patients receiving massive transfusion
    Giancarelli, Amanda
    Birrer, Kara L.
    Alban, Rodrigo F.
    Hobbs, Brandon P.
    Liu-DeRyke, Xi
    JOURNAL OF SURGICAL RESEARCH, 2016, 202 (01) : 182 - 187
  • [4] LONG-TERM OUTCOMES OF PATIENTS RECEIVING A MASSIVE TRANSFUSION AFTER TRAUMA
    Mitra, Biswadev
    Gabbe, Belinda J.
    Kaukonen, Kirsi-Maija
    Olaussen, Alexander
    Cooper, David J.
    Cameron, Peter A.
    SHOCK, 2014, 42 (04): : 307 - 312
  • [5] Improved survival in trauma patients receiving massive transfusion
    Wallace, WC
    Burchell, SA
    Ocariz, J
    Sloan, S
    West, J
    Cinat, ME
    CRITICAL CARE MEDICINE, 1999, 27 (01) : A176 - A176
  • [6] Outcomes of patients receiving a massive transfusion for major trauma
    Endo, A.
    Shiraishi, A.
    Fushimi, K.
    Murata, K.
    Otomo, Y.
    BRITISH JOURNAL OF SURGERY, 2018, 105 (11) : 1426 - 1434
  • [7] Is there a need for fresh frozen plasma and platelet transfusion in trauma patients receiving submassive transfusion?
    Jehan, Faisal
    Zangbar, Bardiya
    Rafieezadeh, Aryan
    Shnaydman, Ilya
    Klein, Joshua
    Con, Jorge
    Prabhakaran, Kartik
    TRAUMA SURGERY & ACUTE CARE OPEN, 2024, 9 (01)
  • [8] Impact of Transfusion Ratios on Mortality after Ultramassive Transfusion Across Nontrauma Surgical Specialties: An Eastern Association for the Surgery of Trauma Multicenter Study
    Matthay, Zachary A.
    Hellmann, Zane J.
    Robinson, Brittany
    Abel, Mary Kathryn
    Chipman, Amanda
    Kozar, Rosemary A.
    Byskosh, Alexandria
    Callcut, Rachael A.
    Kornblith, Lucy Z.
    JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2021, 233 (05) : S278 - S278
  • [9] Outcomes after ultramassive transfusion in the modern era: An Eastern Association for the Surgery of Trauma multicenter study
    Matthay, Zachary A.
    Hellmann, Zane J.
    Callcut, Rachael A.
    Matthay, Ellicott C.
    Nunez-Garcia, Brenda
    Duong, William
    Nahmias, Jeffry
    LaRiccia, Aimee K.
    Spalding, M. Chance
    Dalavayi, Satya S.
    Reynolds, Jessica K.
    Lesch, Heather
    Wong, Yee M.
    Chipman, Amanda M.
    Kozar, Rosemary A.
    Penaloza, Liz
    Mukherjee, Kaushik
    Taghlabi, Khaled
    Guidry, Christopher A.
    Seng, Sirivan S.
    Ratnasekera, Asanthi
    Motameni, Amirreza
    Udekwu, Pascal
    Madden, Kathleen
    Moore, Sarah A.
    Kirsch, Jordan
    Goddard, Jesse
    Haan, James
    Lightwine, Kelly
    Ontengco, Julianne B.
    Cullinane, Daniel C.
    Spitzer, Sarabeth A.
    Kubasiak, John C.
    Gish, Joshua
    Hazelton, Joshua P.
    Byskosh, Alexandria Z.
    Posluszny, Joseph A.
    Ross, Erin E.
    Park, John J.
    Robinson, Brittany
    Abel, Mary Kathryn
    Fields, Alexander T.
    Esensten, Jonathan H.
    Nambiar, Ashok
    Moore, Joanne
    Hardman, Claire
    Terse, Pranaya
    Luo-Owen, Xian
    Stiles, Anquonette
    Pearce, Brenden
    JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2021, 91 (01): : 24 - 33
  • [10] THE INCIDENCE OF HYPOCALCEMIA IN TRAUMA PATIENTS RECEIVING MASSIVE TRANSFUSION PROTOCOL
    Giancarelli, Amanda
    Liu-DeRyke, Xi
    Birrer, Kara
    Hobbs, Brandon
    Alban, Rodrigo
    CRITICAL CARE MEDICINE, 2014, 42 (12)