Quality Management of massive transfusion protocol incorporating tranexamic acid adherence

Weiwei Shi, Ram Al-Sabti, Peter A. Burke, Mauricio Gonzalez, Nelson Mantilla-Rey, Karen Quillen

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)785-789
Number of pages5
JournalTransfusion and Apheresis Science
Volume57
Issue number6
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Keywords

  • Massive transfusion protocol
  • Quality management
  • Tranexamic acid
  • Trauma

ASJC Scopus subject areas

  • Hematology

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