Dr. Minh-Ha Tran from University of California, Irvine joins Dr. Chaffin to discuss Massive Transfusion. Dr. Tran takes us through the “Who, Where, What, Why, When, and How of Massive Transfusion,” offering great insights and perspectives. Massive transfusion can be one of the most challenging (and frightening) situations a blood bank professional can face, and Dr. Tran gives us lots of practical tips to take some of the mystery out of the whole thing!
Use the player above to listen to Episode 007 of the BBGuy Essentials Podcast!
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Tran nor I have any relevant financial disclosures.
The images below are generously provided by Dr. Tran.
- 01:35: Intro to Dr. Tran
- 07:10: Who gets massive transfusions? (Definition)
- 08:15: Nunez et al, “Assessment of Blood Consumption” Score
- 11:15: Other settings for massive transfusion
- 12:20: Where does massive transfusion occur?
- 16:28: How to establish communication with all participants
- 19:25: What is fixed-ratio massive transfusion?
- 27:06: Why do trauma surgeons believe in 1:1:1? (Borgman et al study)
- 30:05: An explanation of “survival bias” in massive transfusion studies
- 35:30: PROPPR study description (Holcomb et al)
- 37:30: PROMMT study description (Holcomb et al)
- 39:30: Riskin et al (Stanford) study description
- 42:50: Why not use fresh whole blood?
- 45:37: How do we choose safe plasma products for massive transfusion?
- 51:33: Summary for three different groups of listeners
- Nunez TC et al. Early prediction of massive transfusion in trauma: Simple as ABC (Assessment of Blood Consumption)?. J Trauma 2009;66:346-52.
- Borgman MA et al. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a Combat Support Hospital. J Trauma 2007;63:805-13.
- Holcomb JB et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 2:1:1 ratio and mortality in patients with severe trauma – The PROPPR randomized clinical trial. JAMA 2015;313(5):471-82.
- Holcomb JB et al. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. JAMA Surg 2013;148(2):127-136.
- Riskin DJ et al. Massive transfusion protocols: The role of aggressive resuscitation versus prudent product ratio in mortality reduction. J Am Coll Surg 2009;209:198-205.
- Zielinski MD et al. Emergency use of pre thawed group A plasma in trauma patients. J Trauma Acute Care Surg 2013;74(1):69-74.