TY - JOUR
T1 - Quality Management of massive transfusion protocol incorporating tranexamic acid adherence
AU - Shi, Weiwei
AU - Al-Sabti, Ram
AU - Burke, Peter A.
AU - Gonzalez, Mauricio
AU - Mantilla-Rey, Nelson
AU - Quillen, Karen
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Massive transfusion protocols (MTP) vary at different institutions. We implemented an algorithm in the transfusion service to support our Level I trauma center in 2007 and periodically monitor MTP utilization as part of ongoing quality management. At the last review in 2013, median plasma: RBC ratio was 1:1.8. We undertook a retrospective 3-year review of MTP activations stratifying by trauma versus non-trauma indications, and blood component utilization of the massive transfusion (MT) cases, adding a review of tranexamic acid (TXA) administration to the audit. The median transfused plasma: RBC ratio was 1:1.9 in trauma MT, and 1:1.6 in the non-trauma MT cases. Non-trauma MT patients at our institution were significantly older and more coagulopathic at MTP initiation compared to trauma MT patients, received fewer RBC units (15.5 versus 20.2), and had higher mortality. TXA adherence increased over the 3-year period to 60% of all trauma MTP activations in 2017.
AB - Massive transfusion protocols (MTP) vary at different institutions. We implemented an algorithm in the transfusion service to support our Level I trauma center in 2007 and periodically monitor MTP utilization as part of ongoing quality management. At the last review in 2013, median plasma: RBC ratio was 1:1.8. We undertook a retrospective 3-year review of MTP activations stratifying by trauma versus non-trauma indications, and blood component utilization of the massive transfusion (MT) cases, adding a review of tranexamic acid (TXA) administration to the audit. The median transfused plasma: RBC ratio was 1:1.9 in trauma MT, and 1:1.6 in the non-trauma MT cases. Non-trauma MT patients at our institution were significantly older and more coagulopathic at MTP initiation compared to trauma MT patients, received fewer RBC units (15.5 versus 20.2), and had higher mortality. TXA adherence increased over the 3-year period to 60% of all trauma MTP activations in 2017.
KW - Massive transfusion protocol
KW - Quality management
KW - Tranexamic acid
KW - Trauma
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U2 - 10.1016/j.transci.2018.10.003
DO - 10.1016/j.transci.2018.10.003
M3 - Article
C2 - 30455154
AN - SCOPUS:85056642224
VL - 57
SP - 785
EP - 789
JO - Transfusion and Apheresis Science
JF - Transfusion and Apheresis Science
SN - 1473-0502
IS - 6
ER -