The status of massive transfusion protocols in United States trauma centers: massive transfusion or massive confusion?

摘要

Massive transfusion, often defined as more than 10 units of red blood cells (RBCs), in the setting of acute trauma is a well-established predictor of mortality. Mortality increases with increasing number of units transfused.1 The recent conflicts in Iraq and Afghanistan have stimulated a rapid shift in paradigms governing massive transfusion after major trauma.2 These paradigm shifts have focused mostly on minimizing intravenous (IV) fluid resuscitation through a greater tolerance for hypotension and the early administration of blood and blood components, particularly fresh-frozen plasma (FFP). The ratio-