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Fixed-ratio transfusion protocol is possible in severe trauma patients

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Researchers found a 1:1:1 blood transfusion protocol for patients with severe trauma is possible in hospitals, but wastes a higher rate of plasma, according to a recently published study.

“These findings suggest that a fixed-ratio transfusion protocol is feasible, but it was associated with increased plasma wastage (about 2 units per patient),” Sandro Rizoli, MD, PhD, trauma program director at St. Michael’s Hospital and professor of surgery and critical care medicine at the University of Toronto, stated in a press release.

Rizoli and colleagues analyzed 78 patients at Sunnybrook Health Sciences Centre with hypertension and bleeding and who were expected to need a massive transfusion, according to the abstract. Of these patients, 40 were assigned to a fixed-ratio transfusion protocol, while 38 patients were assigned to a laboratory-guided transfusion protocol.

The researchers found 57% of patients in the fixed-ratio group achieved a 1:1:1 transfusion protocol compared to 6% of patients in the control group. Additionally, a 1:1:1 transfusion protocol was achieved in 73% of patients in the fixed-ratio group compared to 22% of patients in the control group. Rizoli and colleagues said after 28 days, mortality was higher in the fixed-ratio group at 32.5% compared to 14% of patients in the control group.

Reference:

Nascimento B. Can Med Assoc J. 2013;doi:10.1503/cmaj.121986.

Disclosure:Rizoli is on the advisory board for CSL Behring. This study was funded by grants from the Canadian Forces Health Services, Defense Research and Development Canada and the National Blood Foundation, American Association of Blood Banks.