scholarly journals Management of Massive Blood Transfusion-a case study

Pulse ◽  
2014 ◽  
Vol 5 (1) ◽  
pp. 39-43
Author(s):  
Sufia Khatun Lima ◽  
Monowara Begum ◽  
Anil Kumar Gupta ◽  
Lutful Aziz ◽  
SP Mitra
Keyword(s):  
Blood Transfusion ◽  
Multidisciplinary Approach ◽  
Fresh Frozen Plasma ◽  
General Surgeon ◽  
Blood Products ◽  
Massive Blood Transfusion ◽  
Fresh Frozen ◽  
Transfusion Protocol ◽  
Frozen Plasma

Management of a complicated obstetric patient with profuse bleeding following caesarean section (under GA) required massive blood transfusion was managed properly with multidisciplinary approach in ICU. The involvement of obstetrician, anesthesiologist, intensivist, general surgeon, hematologist & gastroenterologist as a team in a single setup is essential for the management of such patients and the best outcome. The patient received total 117 units of blood products among which 20 units whole blood, 17 units packed red blood cell, 40 units of fresh frozen plasma and 40 units of platelet concentrate. Despite this massive blood transfusion, the patient recovered fully with minimal complications as we follow the near standard blood transfusion protocol. DOI: http://dx.doi.org/10.3329/pulse.v5i1.20189 Pulse Vol.5 January 2011 p.39-43

scholarly journals Clinical Results of a Massive Blood Transfusion Protocol for Postpartum Hemorrhage in a University Hospital in Japan: A Retrospective Study

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 983
Author(s):  
Daigo Ochiai ◽  
Yushi Abe ◽  
Rie Yamazaki ◽  
Tomoe Uemura ◽  
Ayako Toriumi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Blood Cells ◽  
Correlation Coefficients ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Fresh Frozen ◽  
Transfusion Protocol ◽  
Frozen Plasma

Background and objectives: Massive postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide. A massive transfusion protocol (MTP) may be used to provide significant benefits in the management of PPH; however, only a limited number of hospitals use MTP protocol to manage massive obstetric hemorrhages, especially in Japan. This study aimed to assess the clinical outcomes in patients in whom MTP was activated in our hospital. Materials and Methods: We retrospectively reviewed the etiology of PPH, transfusion outcomes, and laboratory findings among the patients treated with MTP after delivery in our hospital. Results: MTP was applied in 24 cases (0.7% of deliveries). Among them, MTP was activated within 2 h of delivery in 15 patients (62.5%). The median estimated blood loss was 5017 mL. Additional procedures to control bleeding were performed in 19 cases, including transarterial embolization (18 cases, 75%) and hysterectomy (1 case, 4.2%). The mean number of units of red blood cells, fresh frozen plasma, and platelets were 17.9, 20.2, and 20.4 units, respectively. The correlation coefficients of any two items among red blood cells, fresh frozen plasma, platelets, blood loss, and obstetrical disseminated intravascular coagulation score ranged from 0.757 to 0.892, indicating high levels of correlation coefficients. Although prothrombin time and activated partial thromboplastin time levels were significantly higher in the <150 mg/dL fibrinogen group than in the ≥150 mg/dL fibrinogen group at the onset of PPH, the amount of blood loss and blood transfusion were comparable between the two groups. Conclusions: Our MTP provides early access to blood products for patients experiencing severe PPH and could contribute to improving maternal outcomes after resuscitation in our hospital. Our study suggests the implementation of a hospital-specific MTP protocol to improve the supply and utilization of blood products to physicians managing major obstetric hemorrhage.

scholarly journals DIFFERENCES IN CHANGES OF HEMOGLOBIN BETWEEN 6-12 HOURS AND 12-14 HOURS AFTER TRANSFUSION

2018 ◽  
Vol 24 (2) ◽  
pp. 108
Author(s):  
Rosita Linda ◽  
Devita Ninda
Keyword(s):  
Blood Transfusion ◽  
Secondary Data ◽  
Hemoglobin Concentration ◽  
Fresh Frozen Plasma ◽  
Blood Components ◽  
Blood Products ◽  
Fresh Frozen ◽  
Frozen Plasma ◽  
Hemoglobin Measurement ◽  
Baseline Hemoglobin

Each year more than 41,000 blood donations are needed every day and 30 million blood components are transfused. Blood products that can be transfused include Packed Red Cells (PRC), Whole Blood (WB), Thrombocyte Concentrate (TC), Fresh Frozen Plasma (FFP). Monitoring Hemoglobin (Hb) after transfusion is essential for assessing the success of a transfusion. The time factor after transfusion for Hemoglobin (Hb) examination needs to be established, analyze to judge the success of a blood transfusion which is performed. The aim of this study was to analyze the differences in changes of hemoglobin between 6-12 hours, and 12-24 hours after-transfusion. This study was retrospective observational using secondary data. The subjects were patients who received PRC, and WBC transfusion. At 6-12, and 12-24 hours after-transfusion, hemoglobin, RBC, and hematocrit were measured. Then the data were analyzed by unpaired t-test. The collected data included the results of the Hb pre-transfusion, 6-12, and 12-24 hours after-transfusion. The subjects of this study were 98 people. The administration of transfusion increased by 10-30% in hemoglobin concentration at 6-12 hours after-transfusion. While at 12-24 hours after-transfusion, hemoglobin after-transfusion increased 15-37% from the baseline. Hemoglobin values were not different at any of the defined after-transfusion times (p = 0.76 (p>0.05)). Hemoglobin values were not different at 6-12 hours, and 12-24 hours after-transfusion.    Keywords: Hemoglobin, measurement, after-transfusion 

The bleeding patient

2020 ◽  
pp. 403-428
Author(s):  
Anne Craig ◽  
Anthea Hatfield
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Disseminated Intravascular Coagulation ◽  
Oxygen Supply ◽  
Fresh Frozen Plasma ◽  
Blood Transfusions ◽  
Massive Blood Transfusion ◽  
Intravascular Coagulation ◽  
Fresh Frozen ◽  
Frozen Plasma

Part one of this chapter tells you about the physiology of blood and oxygen supply, about anaemia and tissue hypoxia, and the physiology of coagulation. Drugs that interfere with clotting are discussed. Bleeding, coagulation, and platelet disorders are covered as well as disseminated intravascular coagulation. Part two is concerned with bleeding in the recovery room: how to cope with rapid blood loss, managing ongoing blood loss, and how to use clotting profiles to guide treatment. There is also a section covering blood transfusion, blood groups and typing. Massive blood transfusion is clearly described, there are guidelines about when to use fresh frozen plasma, when to use platelets, and when to use cryoprecipitate. The final section of the chapter is about problems with blood transfusions.

Transfusion of blood products

2016 ◽  
Author(s):  
Alison Smith
Keyword(s):  
Blood Transfusion ◽  
Carrying Capacity ◽  
Blood Cells ◽  
Fresh Frozen Plasma ◽  
Major Haemorrhage ◽  
Blood Products ◽  
Unlimited Supply ◽  
Fresh Frozen ◽  
Oxygen Carrying Capacity ◽  
Frozen Plasma

The transfusion of blood products may be required in the pre- and post-operative periods. However, there are inherent risks associated with blood transfusion, and there is not an unlimited supply of blood donations available. When a patient is anaemic, red blood cells should be transfused to maintain the oxygen-carrying capacity of blood. Blood products, such as platelets and fresh frozen plasma, are transfused to correct a coagulopathy and during major haemorrhage. This chapter reviews the physiology of blood, including ABO compatibility and rhesus status, the main blood products available for transfusion, and transfusion policy, including the treatment of major haemorrhage and the refusal of blood products.

The bleeding patient

2014 ◽  
Author(s):  
Anthea Hatfield
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Disseminated Intravascular Coagulation ◽  
Oxygen Supply ◽  
Final Section ◽  
Fresh Frozen Plasma ◽  
Blood Transfusions ◽  
Massive Blood Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

Part one of this chapter tells you about the physiology of blood and oxygen supply, about anaemia and tissue hypoxia, and the physiology of coagulation. Drugs that interfere with clotting are discussed. Bleeding, coagulation, and platelet disorders are covered as well as disseminated intravascular coagulation. Part two is concerned with bleeding in the recovery room: how to cope with rapid blood loss, managing ongoing blood loss, and how to use clotting profiles to guide treatment. There is also a section covering blood transfusion, blood groups and typing. Massive blood transfusion is clearly described, there are guidelines about when to use fresh frozen plasma, when to use platelets, and when to use cryoprecipitate. The final section of the chapter is about problems with blood transfusions.

Blood transfusion

2015 ◽  
Author(s):  
Drew Provan ◽  
Trevor Baglin ◽  
Inderjeet Dokal ◽  
Johannes de Vos
Keyword(s):  
Blood Transfusion ◽  
Red Blood Cells ◽  
Intravenous Immunoglobulin ◽  
Blood Cells ◽  
Platelet Transfusion ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Fresh Frozen ◽  
Religious Reasons ◽  
Frozen Plasma

Introduction - Using the blood transfusion laboratory - Transfusion of red blood cells - Platelet transfusion - Fresh frozen plasma - Intravenous immunoglobulin - Transfusion transmitted infections - Irradiated blood products - Strategies for reducing blood transfusion in surgery - Maximum surgical blood ordering schedule (MSBOS) - Patients refusing blood transfusion for religious reasons, i.e. Jehovah’s Witnesses

Blood transfusion

2018 ◽  
Author(s):  
Drew Provan ◽  
Trevor Baglin ◽  
Inderjeet Dokal ◽  
Johannes de Vos ◽  
Shubha Allard ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Red Blood Cells ◽  
Intravenous Immunoglobulin ◽  
Blood Cells ◽  
Platelet Transfusion ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Fresh Frozen ◽  
Religious Reasons ◽  
Frozen Plasma

Introduction - Using the blood transfusion laboratory - Transfusion of red blood cells - Platelet transfusion - Fresh frozen plasma - Intravenous immunoglobulin - Transfusion transmitted infections - Irradiated blood products - Strategies for reducing blood transfusion in surgery - Maximum surgical blood ordering schedule (MSBOS) - Patients refusing blood transfusion for religious reasons, i.e. Jehovah’s Witnesses

Fresh frozen plasma (FFP) use during massive blood transfusion in trauma resuscitation

Injury ◽  
2010 ◽  
Vol 41 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Biswadev Mitra ◽  
Alfredo Mori ◽  
Peter A. Cameron ◽  
Mark Fitzgerald ◽  
Eldho Paul ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Fresh Frozen Plasma ◽  
Trauma Resuscitation ◽  
Massive Blood Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

Massive Transfusion Protocols in Obstetric Hemorrhage: Theory versus Reality

2021 ◽  
Author(s):  
Bahram Salmanian ◽  
Steven L. Clark ◽  
Shiu-Ki R. Hui ◽  
Sarah Detlefs ◽  
Soroush Aalipour ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Massive Transfusion ◽  
Fresh Frozen Plasma ◽  
Laboratory Evaluation ◽  
Blood Products ◽  
Massive Transfusion Protocol ◽  
Fresh Frozen ◽  
Transfusion Protocol ◽  
Frozen Plasma

Objective Massive transfusion protocols are widely implemented in obstetrical practice in case of severe hemorrhage; however, different recommendations exist regarding the appropriate ratios of blood product components to be transfused. We report our extensive experience with massive component transfusion in a referral center in which the standard massive transfusion protocol is modified by ongoing clinical and laboratory evaluation. Study Design A retrospective chart review of all patients who had massive transfusion protocol activation in a level 4 referral center for obstetrical practice was performed from January 2014 to January 2020. Data collected included the etiology of obstetrical hemorrhage, number of blood products of each type transfused, crystalloid infusion, and several indices of maternal morbidity and mortality. Data are presented with descriptive statistics. Results A total of 62 patients had massive transfusion protocol activation, of which 97% received blood products. Uterine atony was found to be the most common etiology for massive hemorrhage (34%), followed by placenta accreta spectrum (32%). The mean estimated blood loss was 1,945 mL. A mean of 6.5 units of packed red blood cells, 14.8 units of fresh frozen plasma and cryoprecipitate, and 8.3 units of platelets were transfused per patient. No maternal deaths were seen. Conclusion The ratios of transfused packed red blood cell to fresh frozen plasma/cryoprecipitate and of packed red blood cell to platelet units varied significantly from the fixed initial infusion ratio called for by our massive transfusion protocol resulting in universally favorable maternal outcomes. When rapid laboratory evaluation of hematologic and clotting parameters is available, careful use of this information may facilitate safe modification of an initial fixed transfusion ratio based on etiology of the hemorrhage and individual patient response. Key Points

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