Liquid plasma use during "super" massive transfusion protocol

Casey J. Allen, Sherry Shariatmadar, Jonathan P. Meizoso, Mena M. Hanna, Jose L. Mora, Juliet J. Ray, Nicholas Namias, Roman Dudaryk, Kenneth G Proctor

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: A massive transfusion protocol (MTP) presents a logistical challenge for most blood banks and trauma centers. We compare the ratio of packed red blood cells (PRBC) and plasma transfused over serial time points in those requiring MTP (10-30 U PRBC/24 h) to those requiring "super" MTP (S-MTP; >30 U PRBC/24 h) and test the hypothesis that changes in allocation of blood products with use of readily transfusable liquid plasma (LP) improves the ratio of PRBC and plasma during S-MTP.

MATERIALS AND METHODS: All transfused trauma patients (n = 1305) from January 01, 2009-April, 03, 2015 were reviewed. PRBC:plasma ratio was compared for MTP (n = 277) and S-MTP (n = 61) patients, before and after the availability of LP at our institution. Data are reported as mean ± standard deviation or median (interquartile range).

RESULTS: Age was 41 ± 19 y, 52% blunt mechanism, injury severity score 32 ± 16, and 46.3% mortality. In 24 h, requirements were 17 (14) U PRBC and 10 (11) U plasma, with a PRBC:plasma of 1.6 (0.8). Within the first hour, PRBC:plasma for S-MTP versus MTP was 2.1:1 versus 1.7:1 (P = 0.017). With LP, S-MTP patients received significantly lower PRBC:plasma at the first hour (P < 0.001). Before institutional changes, PRBC:plasma positively correlated with PRBC transfused at hour 1 (r = 0.410, R(2) = 0.168, P < 0.001); after institutional changes and the advent of LP, there was no correlation (r = 0.177, R(2) = 0.031, P = 0.219).

CONCLUSIONS: Within the first hour of transfusion, units of PRBC transfused positively correlated with PRBC:plasma, and patients receiving S-MTP had higher PRBC:plasma than those receiving MTP. Changes in our institution's MTP protocol to include LP improved the early PRBC:plasma transfused in patients requiring S-MTP.

Original languageEnglish (US)
Pages (from-to)622-628
Number of pages7
JournalThe Journal of surgical research
Volume199
Issue number2
DOIs
StatePublished - Dec 1 2015

Fingerprint

Erythrocytes
Blood Banks
Nonpenetrating Wounds
Injury Severity Score
Trauma Centers
Mortality

Keywords

  • Acute coagulopathy of trauma
  • FFP
  • Hemostatic resuscitation
  • MTP

ASJC Scopus subject areas

  • Surgery

Cite this

Allen, C. J., Shariatmadar, S., Meizoso, J. P., Hanna, M. M., Mora, J. L., Ray, J. J., ... Proctor, K. G. (2015). Liquid plasma use during "super" massive transfusion protocol. The Journal of surgical research, 199(2), 622-628. https://doi.org/10.1016/j.jss.2015.06.022

Liquid plasma use during "super" massive transfusion protocol. / Allen, Casey J.; Shariatmadar, Sherry; Meizoso, Jonathan P.; Hanna, Mena M.; Mora, Jose L.; Ray, Juliet J.; Namias, Nicholas; Dudaryk, Roman; Proctor, Kenneth G.

In: The Journal of surgical research, Vol. 199, No. 2, 01.12.2015, p. 622-628.

Research output: Contribution to journalArticle

Allen CJ, Shariatmadar S, Meizoso JP, Hanna MM, Mora JL, Ray JJ et al. Liquid plasma use during "super" massive transfusion protocol. The Journal of surgical research. 2015 Dec 1;199(2):622-628. https://doi.org/10.1016/j.jss.2015.06.022
Allen, Casey J. ; Shariatmadar, Sherry ; Meizoso, Jonathan P. ; Hanna, Mena M. ; Mora, Jose L. ; Ray, Juliet J. ; Namias, Nicholas ; Dudaryk, Roman ; Proctor, Kenneth G. / Liquid plasma use during "super" massive transfusion protocol. In: The Journal of surgical research. 2015 ; Vol. 199, No. 2. pp. 622-628.
@article{1e6b1ec66b184745a43f002279872e38,
title = "Liquid plasma use during {"}super{"} massive transfusion protocol",
abstract = "BACKGROUND: A massive transfusion protocol (MTP) presents a logistical challenge for most blood banks and trauma centers. We compare the ratio of packed red blood cells (PRBC) and plasma transfused over serial time points in those requiring MTP (10-30 U PRBC/24 h) to those requiring {"}super{"} MTP (S-MTP; >30 U PRBC/24 h) and test the hypothesis that changes in allocation of blood products with use of readily transfusable liquid plasma (LP) improves the ratio of PRBC and plasma during S-MTP.MATERIALS AND METHODS: All transfused trauma patients (n = 1305) from January 01, 2009-April, 03, 2015 were reviewed. PRBC:plasma ratio was compared for MTP (n = 277) and S-MTP (n = 61) patients, before and after the availability of LP at our institution. Data are reported as mean ± standard deviation or median (interquartile range).RESULTS: Age was 41 ± 19 y, 52{\%} blunt mechanism, injury severity score 32 ± 16, and 46.3{\%} mortality. In 24 h, requirements were 17 (14) U PRBC and 10 (11) U plasma, with a PRBC:plasma of 1.6 (0.8). Within the first hour, PRBC:plasma for S-MTP versus MTP was 2.1:1 versus 1.7:1 (P = 0.017). With LP, S-MTP patients received significantly lower PRBC:plasma at the first hour (P < 0.001). Before institutional changes, PRBC:plasma positively correlated with PRBC transfused at hour 1 (r = 0.410, R(2) = 0.168, P < 0.001); after institutional changes and the advent of LP, there was no correlation (r = 0.177, R(2) = 0.031, P = 0.219).CONCLUSIONS: Within the first hour of transfusion, units of PRBC transfused positively correlated with PRBC:plasma, and patients receiving S-MTP had higher PRBC:plasma than those receiving MTP. Changes in our institution's MTP protocol to include LP improved the early PRBC:plasma transfused in patients requiring S-MTP.",
keywords = "Acute coagulopathy of trauma, FFP, Hemostatic resuscitation, MTP",
author = "Allen, {Casey J.} and Sherry Shariatmadar and Meizoso, {Jonathan P.} and Hanna, {Mena M.} and Mora, {Jose L.} and Ray, {Juliet J.} and Nicholas Namias and Roman Dudaryk and Proctor, {Kenneth G}",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.jss.2015.06.022",
language = "English (US)",
volume = "199",
pages = "622--628",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Liquid plasma use during "super" massive transfusion protocol

AU - Allen, Casey J.

AU - Shariatmadar, Sherry

AU - Meizoso, Jonathan P.

AU - Hanna, Mena M.

AU - Mora, Jose L.

AU - Ray, Juliet J.

AU - Namias, Nicholas

AU - Dudaryk, Roman

AU - Proctor, Kenneth G

PY - 2015/12/1

Y1 - 2015/12/1

N2 - BACKGROUND: A massive transfusion protocol (MTP) presents a logistical challenge for most blood banks and trauma centers. We compare the ratio of packed red blood cells (PRBC) and plasma transfused over serial time points in those requiring MTP (10-30 U PRBC/24 h) to those requiring "super" MTP (S-MTP; >30 U PRBC/24 h) and test the hypothesis that changes in allocation of blood products with use of readily transfusable liquid plasma (LP) improves the ratio of PRBC and plasma during S-MTP.MATERIALS AND METHODS: All transfused trauma patients (n = 1305) from January 01, 2009-April, 03, 2015 were reviewed. PRBC:plasma ratio was compared for MTP (n = 277) and S-MTP (n = 61) patients, before and after the availability of LP at our institution. Data are reported as mean ± standard deviation or median (interquartile range).RESULTS: Age was 41 ± 19 y, 52% blunt mechanism, injury severity score 32 ± 16, and 46.3% mortality. In 24 h, requirements were 17 (14) U PRBC and 10 (11) U plasma, with a PRBC:plasma of 1.6 (0.8). Within the first hour, PRBC:plasma for S-MTP versus MTP was 2.1:1 versus 1.7:1 (P = 0.017). With LP, S-MTP patients received significantly lower PRBC:plasma at the first hour (P < 0.001). Before institutional changes, PRBC:plasma positively correlated with PRBC transfused at hour 1 (r = 0.410, R(2) = 0.168, P < 0.001); after institutional changes and the advent of LP, there was no correlation (r = 0.177, R(2) = 0.031, P = 0.219).CONCLUSIONS: Within the first hour of transfusion, units of PRBC transfused positively correlated with PRBC:plasma, and patients receiving S-MTP had higher PRBC:plasma than those receiving MTP. Changes in our institution's MTP protocol to include LP improved the early PRBC:plasma transfused in patients requiring S-MTP.

AB - BACKGROUND: A massive transfusion protocol (MTP) presents a logistical challenge for most blood banks and trauma centers. We compare the ratio of packed red blood cells (PRBC) and plasma transfused over serial time points in those requiring MTP (10-30 U PRBC/24 h) to those requiring "super" MTP (S-MTP; >30 U PRBC/24 h) and test the hypothesis that changes in allocation of blood products with use of readily transfusable liquid plasma (LP) improves the ratio of PRBC and plasma during S-MTP.MATERIALS AND METHODS: All transfused trauma patients (n = 1305) from January 01, 2009-April, 03, 2015 were reviewed. PRBC:plasma ratio was compared for MTP (n = 277) and S-MTP (n = 61) patients, before and after the availability of LP at our institution. Data are reported as mean ± standard deviation or median (interquartile range).RESULTS: Age was 41 ± 19 y, 52% blunt mechanism, injury severity score 32 ± 16, and 46.3% mortality. In 24 h, requirements were 17 (14) U PRBC and 10 (11) U plasma, with a PRBC:plasma of 1.6 (0.8). Within the first hour, PRBC:plasma for S-MTP versus MTP was 2.1:1 versus 1.7:1 (P = 0.017). With LP, S-MTP patients received significantly lower PRBC:plasma at the first hour (P < 0.001). Before institutional changes, PRBC:plasma positively correlated with PRBC transfused at hour 1 (r = 0.410, R(2) = 0.168, P < 0.001); after institutional changes and the advent of LP, there was no correlation (r = 0.177, R(2) = 0.031, P = 0.219).CONCLUSIONS: Within the first hour of transfusion, units of PRBC transfused positively correlated with PRBC:plasma, and patients receiving S-MTP had higher PRBC:plasma than those receiving MTP. Changes in our institution's MTP protocol to include LP improved the early PRBC:plasma transfused in patients requiring S-MTP.

KW - Acute coagulopathy of trauma

KW - FFP

KW - Hemostatic resuscitation

KW - MTP

UR - http://www.scopus.com/inward/record.url?scp=85027936475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027936475&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2015.06.022

DO - 10.1016/j.jss.2015.06.022

M3 - Article

C2 - 26182996

AN - SCOPUS:85027936475

VL - 199

SP - 622

EP - 628

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -