What is the massive transfusion protocol?
“Massive Transfusion Protocol” (MTP) refers to rapid administration of large amounts of blood products (at least 6 units of PRBC) in fixed ratios (usually 1:1:1) for the management of hemorrhagic shock. Only a subset of patients with “massive transfusion” will receive a massive transfusion protocol.
When should massive transfusion protocol be activated?
Massive transfusion protocols are activated by a clinician in response to massive bleeding. Generally this is activated after transfusion of 4-10 units. MTPs have a predefined ratio of RBCs, FFP/cryoprecipitate and platelets units (random donor platelets) in each pack (e.g. 1:1:1 or 2:1:1 ratio) for transfusion.
What machine is used for blood transfusions?
Hemosep, as it is known, is designed for use during major surgery. It removes blood from the surgical site, takes out the plasma and returns the vital blood cells to the patient, all through a single lightweight device. The key is a special plastic bag into which the recovered blood is poured.
What are the possible complications of massive transfusion?
Some of the complications of massive transfusion include:
- hypothermia.
- dilutional coagulopathy.
- hypocalcaemia, hypomagnesaemia, citrate toxicity.
- metabolic acidosis.
- hyperkalaemia and hypokalaemia.
- immune haemolysis, and.
- air embolism.
How do you treat massive blood loss?
The three key elements in the treatment of massive bleeding are volume expansion or replacement with crystalloids and colloids, the optimization of tissue oxygenation with the transfusion of red cells, and the correction of coagulopathy. In general, the principles described below should be followed.
What complications are likely to occur in the patient who receives massive blood transfusions within a short period of time?
Complications of massive transfusion include the following:
- Coagulopathy is caused by a dilutional effect on the host’s clotting factors and platelets, as well as the lack of platelets and clotting factors in packed red blood cells.
- Volume overload.
- Hypothermia.
How much blood is considered a massive transfusion?
In adults, massive transfusion can be defined as replacement of >1 blood volume in 24 hours or >50% of blood volume in 4 hours (adult blood volume is approximately 70 mL/kg).
How does a blood transfusion machine work?
During a blood transfusion, a healthcare professional will place a small needle into the vein, usually in the arm or hand. The blood then moves from a bag, through a rubber tube, and into the person’s vein through the needle. They will carefully monitor vital signs throughout the procedure.
What are the types of blood transfusion?
Common types of blood transfusions include red blood cell, platelet and plasma transfusions.
- Red Blood Cell Transfusions.
- Platelet Transfusions.
- Plasma Transfusions.
Why does massive transfusion cause hyperkalemia?
Potassium in stored blood increases due to decrease in ATP production and leakage of potassium into the supernatant. The initial high levels of potassium in stored blood predispose to post-transfusion hyperkalemia. Cardiac arrest has been commonly reported in transfusion-associated hyperkalemia.
How might one intervene for massive bleeding?
Bleeding may be stopped temporarily by external compression and/or tourniquets. However, surgical or interventional (e.g. arterial embolization) repair is required for final hemorrhage control [3].
Which electrolyte disturbances may be present due to resuscitation and massive transfusion?
Two common electrolyte abnormalities that occur in MTP are hypocalcemia, caused by the preservative citrate and hyperkalemia. Aboudara et al[66] show that after transfusion of 7 units of PRBCs, the patient is at risk for hyperkalemia.