scholarly journals Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste

2015 ◽  
Vol 8 (4) ◽  
pp. 199 ◽  
Author(s):  
Kirsten Balvers ◽  
Michiel Coppens ◽  
Susan van Dieren ◽  
IngeborgH.M. van Rooyen-Schreurs ◽  
HenriëtteJ Klinkspoor ◽  
...  
Keyword(s):  
Blood Product ◽  
Massive Transfusion ◽  
Product Ratio ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

Intraoperative Resuscitation by Specialized Trauma Nurse Clinicians Improves Adherence to Massive Transfusion Protocol

2020 ◽  
Vol 86 (1) ◽  
pp. 35-41
Author(s):  
L. Andrew May ◽  
Kevin N. Harrell ◽  
Christopher M. Bell ◽  
Angela Basham-Saif ◽  
Donald E. Barker ◽  
...  
Keyword(s):  
Blood Product ◽  
Trauma Registry ◽  
Massive Transfusion ◽  
Blood Products ◽  
Packed Red Blood Cells ◽  
Massive Blood Loss ◽  
Massive Transfusion Protocol ◽  
Nurse Clinicians ◽  
Level I ◽  
Transfusion Protocol

A massive transfusion protocol (MTP) was implemented at a Level I trauma center in 2007 for patients with massive blood loss. A goal ratio of plasma to pheresed platelets to packed red blood cells (PRBCs) of 1:1:1 was established. From 2007 to 2014, trauma nurse clinicians (TNCs) administered the MTP during initial resuscitation and anesthesia personnel administered the MTP intraoperatively. In 2015, TNCs began administering the MTP intraoperatively. This study evaluates intraoperative blood product ratios and crystalloid volume administered by anesthesia personnel or TNCs. A retrospective review of trauma registry patients requiring MTP from 2007 to 2017 was performed. Patient data were stratified according to MTP administration by either anesthesia personnel (2007–2015) or TNCs (2015–2017). Ninety-seven patients were included with 54 anesthesia patients and 44 TNC patients. Patients undergoing resuscitation by MTP administered by TNCs received less median crystalloid (3000 mL vs 1500 mL, P < 0.001). The ratio of plasma:PRBC (0.75 vs 0.93, P = 0.027) and platelets:PRBC (0.75 vs 1.04, P = 0.003) was found to be significantly closer to 1:1 for TNC patients. MTP intraoperative blood product administration by TNCs reduced the amount of infused crystalloid and improved adherence to MTP in achieving a 1:1:1 ratio of blood products.

scholarly journals Massive Transfusion Protocol Over-Activation

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S164-S165
Author(s):  
M Abdelmonem ◽  
H Wasim ◽  
M Abdelmonem
Keyword(s):  
Blood Transfusion ◽  
Blood Cells ◽  
Blood Product ◽  
Massive Transfusion ◽  
Labor And Delivery ◽  
Massive Blood Transfusion ◽  
Packed Red Blood Cells ◽  
Massive Transfusion Protocol ◽  
The Difference ◽  
Transfusion Protocol

Abstract Introduction/Objective Massive blood transfusion protocol (MTP) is revealed in many cases, such as massive hemorrhage after surgeries, trauma settings, and labor and delivery. Patients who require blood transfusion of more than ten units of packed red blood cells in 24 hours or transfusion of more than four units of packed red blood cells (PRBCs) in one hour are the massive blood transfusion protocol candidates. Methods/Case Report A retrospective study was performed at a 225-bed level III trauma center in California. The overall massive blood transfusion protocol utilization, blood product emergency release, and blood product waste were recorded twelve months before and after launching an educational and collaboration program between blood banks and clinicians about the difference between massive transfusion protocol and blood emergency release. Results (if a Case Study enter NA) MTP utilization for the 12 months (June 2017 to June 2018) was demonstrated as 59 MTP activations: 32 MTPs from the emergency department, 4 MTPs from inpatient floors, 3 MTPs from labor and delivery, and 4 MTPs from operating rooms while the blood product emergency releases were 7 emergency releases. MTP utilization from (June 2018 to June 2019) was demonstrated as 15 MTP activations: 11 MTPs from the emergency department, 2 MTPs from inpatient floors, 1 MTPs from labor and delivery, and 1 MTPs from operating rooms, while the blood product emergency releases were 43 emergency releases. The blood product waste was reduced by 44.6% in 2018. Conclusion There was a significant reduction in MTP activation and blood product waste after implementing the educational program for the clinicians. The collaboration between the blood bank and the clinicians and coordinating educational sessions for clinicians about the difference between MTP and emergency release and the negative impact of the MTP over-activation on the blood product waste and the clinical laboratory scientists in the blood bank is vital in MTP utilization.

1165: MASSIVE TRANSFUSION PROTOCOL IN A COMMUNITY NONTRAUMA SETTING: IS BLOOD PRODUCT WASTAGE AVOIDABLE?

2016 ◽  
Vol 44 (12) ◽  
pp. 367-367
Author(s):  
Noubar Kevorkian ◽  
Sharon Weintraub ◽  
Nancy Bienkowski ◽  
Peg Basch ◽  
Stacy Pagliaruli ◽  
...  
Keyword(s):  
Blood Product ◽  
Massive Transfusion ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

scholarly journals Four-factor prothrombin complex concentrate to reduce allogenic blood product transfusion in patients with major trauma, the PROCOAG trial: study protocol for a randomized multicenter double-blind superiority study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pierre Bouzat ◽  
Jean-Luc Bosson ◽  
Jean-Stéphane David ◽  
Bruno Riou ◽  
Jacques Duranteau ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Prothrombin Complex Concentrate ◽  
Blood Product ◽  
Massive Transfusion ◽  
Severe Trauma ◽  
Trauma Patients ◽  
Double Blind ◽  
Massive Transfusion Protocol ◽  
Post Traumatic ◽  
Transfusion Protocol

Abstract Background Optimal management of severe trauma patients with active hemorrhage relies on adequate initial resuscitation. Early administration of coagulation factors improves post-traumatic coagulation disorders, and four-factor prothrombin complex concentrate (PCC) might be useful in this context. Our main hypothesis is that four-factor PCC in addition to a massive transfusion protocol decreases blood product consumption at day 1 in severe trauma patients with major bleeding. Methods This is a prospective, randomized, multicenter, double-blind, parallel, controlled superiority trial. Eligible patients are trauma patients with major bleeding admitted to a French level-I trauma center. Patients randomized in the treatment arm receive 1 mL/kg (25 IU/ml of Factor IX/Kg) four-factor PCC within 1-h post-admission while patients randomized in the controlled group receive 1 mL/kg of saline solution 0.9% as a placebo. Treatments are given as soon as possible using syringe pumps (120 mL/h). The primary endpoint is the amount of blood products transfused in the first 24 h post-admission (including red blood cells, frozen fresh plasma, and platelets). The secondary endpoints are the amount of each blood product transfused in the first 24 h, time to achieve prothrombin time ratio < 1.5, time to hemostasis, number of thrombo-embolic events at 28 days, mortality at 24 h and 28 days, number of intensive care unit-free days, number of ventilator-free days, number of hospital-free days within the first 28 days, hospitalization status at day 28, Glasgow outcome scale extended for patients with brain lesions on initial cerebral imaging, and cost of each strategy at days 8 and 28. Inclusions have started in December 2017 and are expected to be complete by June 2021. Discussion If PCC reduces total blood consumption at day 1 after severe trauma, this therapy, in adjunction to a classic massive transfusion protocol, may be used empirically on admission in patients at risk of massive transfusion to enhance coagulation. Moreover, this treatment may decrease blood product-related complications and may improve clinical outcomes after post-traumatic hemorrhage. Trial registration ClinicalTrials.gov NCT03218722. Registered on July 14, 2017

scholarly journals Four-Factor Prothrombin Complex Concentrate to Reduce Post-Traumatic Hemorrhage in Patients with Major Trauma, the PROCOAG Trial: Study Protocol for a Randomized Multicenter Double-Blind Superiority Study

2021 ◽  
Author(s):  
Pierre Bouzat ◽  
Jean-Luc Bosson ◽  
Jean-Stéphane David ◽  
Bruno Riou ◽  
Jacques Duranteau ◽  
...  
Keyword(s):  
Prothrombin Complex Concentrate ◽  
Blood Product ◽  
Massive Transfusion ◽  
Severe Trauma ◽  
Trauma Patients ◽  
Double Blind ◽  
Massive Transfusion Protocol ◽  
Post Traumatic ◽  
Traumatic Hemorrhage ◽  
Transfusion Protocol

Abstract Background: Optimal management of severe trauma patients with active hemorrhage relies on adequate initial resuscitation. Early administration of coagulation factors improves post-traumatic coagulation disorders and four-factor prothrombin complex concentrate (PCC) might be useful in this context. Our main hypothesis is that four-factor PCC in addition to a massive transfusion protocol decrease blood product consumption at day one in severe trauma patients with major bleeding.Methods This is a prospective, randomized, multicenter, double-blind, parallel, controlled superiority trial. Eligible patients are trauma patients with major bleeding admitted to a French level-I trauma centre. Patients randomized in the treatment arm receive 1 mL/kg four-factor PCC within one-hour post-admission while patients randomized in the controlled group receive 1 mL/kg of saline solution 0.9% as a placebo. The primary endpoint is the amount of blood products transfused in the first 24 hours post-admission (including red blood cells, frozen fresh plasma and platelets). The secondary endpoints are the amount of each blood product transfused in the first 24 hours, time to achieve prothrombin time ratio < 1.5, time to hemostasis, number of thrombo-embolic events at 28 days, mortality at 24 hours and 28 days, number of intensive care unit (ICU)-free days, number of ventilator-free days during ICU stay, number of hospital-free days within the first 28 days, hospitalization status at day 28, Glasgow outcome scale extended for patients with brain lesions on initial cerebral imaging, and cost of each strategy at day 8 and 28. Inclusions have started in December 2017 and are expected to be complete by June 2021. Discussion: If PCC reduces total blood consumption at day one after severe trauma, this therapy, in adjunction to a classic massive transfusion protocol, may be used empirically on admission in patients at risk of massive transfusion to enhance coagulation. Moreover, this treatment may decrease blood product related complications and may improve clinical outcome after post-traumatic hemorrhage. Trial registration: This study has been prospectively registered on clinical trial on July 14, 2017 NCT03218722

Blood Provision for Cardiac Ablation (CA) Procedures in the Catheterization Laboratory; a Veteran Affairs Medical Center (VAMC) Experience in a Non-Trauma Center Setting

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S167-S168
Author(s):  
J M Petersen ◽  
V Patel ◽  
D Jhala
Keyword(s):  
Quality Assurance ◽  
Massive Transfusion ◽  
Medical Center ◽  
Case Series ◽  
Blood Bank ◽  
Cardiac Ablation ◽  
Cardiac Perforation ◽  
Catheterization Laboratory ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

Abstract Introduction/Objective Cardiac perforation is a life-threatening complication (~1% risk, with reported rates between 0.2% to 5%) of CA procedures. As cardiac perforation may lead to extensive bleeding, it would be reasonable for a medical center carrying out CA to be capable of arranging for a massive transfusion protocol and for surgical repair as required. However, there is sparse literature to guide a non-trauma medical center implementing a CA program on what the number of red blood cell (RBC) units for crossmatch should be for each case. Methods In interdisciplinary collaborative meetings, the CA program logistics were agreed to between the multiple clinical services. Given the case series on the amount of drained blood in complicated cases, there was agreement that three units of RBCs would be crossmatched for each case. Education was provided on the massive transfusion protocol and on blood bank procedures. As part of quality assurance/quality improvement, records were reviewed from the beginning of the CA program (10/1/2019) to 1/31/2019 to determine number of patient cases, crossmatched units, and transfused units for quality assurance purposes. Results A total of fifteen patients underwent CA procedures, for which three units were crossmatched for each patient. As there were no cardiac perforations with the cardiac ablation procedures so far, no units were transfused. The organized approach for ensuring adequate blood bank support and education led to the reassurance, alleviation of clinical anxiety, and building of a successful CA program. Education sessions completed with thorough understanding of blood bank procedures including the massive transfusion protocol, labeling of blood bank specimens, and on ordering of blood for crossmatch. Conclusion This study provides a reference that may provide helpful guidance to other blood banks on what the number of RBCs to be crossmatched prior to each CA procedure. Multidisciplinary collaborative meetings in advance are an essential component for ensuring adequate support for CA procedures or any new service that requires blood product support. Thorough education of clinical staff on blood bank procedures particularly the massive transfusion protocol is also recommended. This procedure for massive transfusion should be available to be referred to in real time.

Sign in / Sign up

Export Citation Format

Share Document