ABSTRACT
Massive transfusion (MT) is generally defined as greater than or equal to 10 units of blood over 24 hours, although alternative volumes have been described. For patients that require continued transfusion, the development of massive transfusion protocols allow the surgeon to notify the blood bank of their need for delivery of coolers with packed red blood cells and thawed plasma and delivery of platelets at room temperature. The traditional definition of MT is merely a static volume that does not account for different rates of transfusion over time and potentially different underlying pathophysiology. Rethinking the way MT is defined in which survivor bias, volume, and rate of transfusion are addressed, can provide more granular data when investigating resuscitation in hemorrhagic shock. Current guidelines for damage control resuscitation in patients with severe traumatic hemorrhage recommend development and utilization of massive transfusion protocols and damage control resuscitation that target a high ratio of plasma and platelets to pac.
