Management of Patients with Massive Transfusion

Death following massive hemorrhage remains the top cause of death. At least 15% of trauma-related deaths are potentially preventable by rapid hemorrhage control and aggressive transfusion strategies. Rapid transfusion of large volumes of blood products is needed in cases with hemorrhagic shock which may lead to a unique set of complications. In recent times, such cases are managed using a protocol-based method. Protocol-based management of these cases using massive transfusion protocol has shown better outcomes. Massive transfusion protocol (MTP) is a standardized approach to management of cases who bear large volumes of blood products due to massive hemorrhage. Massive transfusion protocol aims to provide rapid and effective resuscitation, reduce transfusion-related complications, and better patient outcomes. In this chapter, definitions of massive transfusion, pathophysiology of massive transfusion, components of management of massive transfusion protocol, point-of-care testing, adjunct therapies, complications of massive transfusion, and recent updates in management of massive transfusion are discussed.