Yonsei Med J.  2011 May;52(3):469-475. 10.3349/ymj.2011.52.3.469.

Clinical Observation Study of Massive Blood Transfusion in a Tertiary Care Hospital in Korea

• Yoon S
• Park AJ
• Kim HO

• KMID: 1777019
• DOI: http://doi.org/10.3349/ymj.2011.52.3.469

Abstract

PURPOSE
Massive blood transfusios are uncommon. The goal of this study was to propose an ideal ratio for the blood component of massive hemorrhage treatment after review of five years of massive transfusion practice, in order to have the best possible clinical outcomes.
MATERIALS AND METHODS
We defined a 'massive transfusion' as receiving 10 or more units of red blood cells in one day. A list of patients receiving a massive transfusion from 2004 to 2008 was generated using the electronic medical records. For each case, we calculated the ratio of blood components and examined its relationship to their survival.
RESULTS
Three hundred thirty four patients underwent massive transfusion during the five years of the study. The overall seven-day hospital mortality for massive transfusion patients was 26.1%. Factors independently predictive of survival were a fresh-frozen plasma (FFP)/packed red blood cell (pRBC) ratio> or =1.1 with an odds ratio (OR) of 1.96 (1.03-3.70), and elective admission with an OR of 2.6 (1.52-4.40). The receiver operation characteristic (ROC) curve suggest that a 1 : 1 : 1 ratio of pRBCs to FFP to platelets is the best ratio for survival.
CONCLUSION
Fixing blood-component ratios during active hemorrhage shows improved outcomes. Thus, the hospital blood bank and physician hypothesized that a fixed blood component ratio would help to reduce mortality and decrease utilization of the overall blood component.

Keyword

Massive transfusion; fixed ratio; transfusion

MeSH Terms

Adult
Blood Cell Count
Blood Transfusion/*methods
Female
Hospitals
Humans
Male
Middle Aged
Republic of Korea
Retrospective Studies
Treatment Outcome

Figure

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  Fig. 1 ROC curves of each blood product ratio. ROC, receiver operation characteristic.

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