Protocol of Massive Transfusion (MTP) — A Systematic Review

Résumé

Introduction: MTP has been widely adopted for the care of bleeding trauma patients but its actual effectiveness is uncertain even today. MTP is an efficient way of ensuring of blood components to rapidly exsanguinating patients. For effective management of severely injured patients, regardless of etiology (trauma, obstetrical, surgical), effective preparation of MPT is needed. Methods and Materials: This review included 9 original studies that reported the effect of the implementation of an MTP on trauma patients. It shows that MTP implementation improves overall survival, with a statistically significant reduction in the overall mortality. The total study population was 4245. Results: MTP significantly reduced the overall mortality for trauma patients (OR 0.71 [0.56-0.90]). No significant reduction was seen in either the 24-hour mortality (OR 0.81 [0.57-1.14]) or the 30-day mortality (OR 0.73 [0.46-1.16]). In GMS MTP patients, there was a statistically significant increase in the percentage of platelet units wasted (MTP 12.8% vs non-MTP 8.1%; p ¼ 0.046). This increase was also seen in trauma MTP patients (MTP 12.2% vs non-MTP 4.0%; p < 0.001). No statistically significant difference was found in 24 -h death rate (15.0% vs. 23.8%, p = 0.181). The ABC scoring system used for trauma patients had a sensitivity and specificity of 81.8% and 41.2%, respectively. Conclusion: MTP may be used for both trauma and non-trauma patients to improve the outcomes of patients.