Department of Surgery, Section of Trauma, Surgical Critical Care and Surgical Emergencies, Yale University School of Medicine, New Haven, Connecticut 06520-8062, USA.
Transfusion. 2010 Jul;50(7):1545-51. doi: 10.1111/j.1537-2995.2010.02587.x. Epub 2010 Feb 11.
Massive transfusion protocol (MTP) utilization and makeup is unknown.
A Web-based survey was sent to members of the Eastern Association for the Surgery of Trauma and published in the American Association for the Surgery of Trauma newsletter. Comparisons were made with chi-square and logistic regression.
A total of 186 surgeons and 59 center directors responded. To avoid bias, directors' responses are reported. Sixty percent annually admit more than 1500 patients. Sixty-seven percent had in-house attending coverage and 85% had a MTP. Presence of a MTP was not predicted by institution size, level, residency status, or admissions. Sixty-five percent of MTPs had been in place less than 5 years with 18% less than 1 year. Designs varied: 23% had one batch of components, 25% had two or three, 41% had more than three, and 11% did not use batches. Only 62% of first batches contained fresh-frozen plasma (FFP). In the second batch 98% had FFP. All third boxes had FFP. A ratio of FFP : red blood cells (RBCs) of less than 1 in the first batch predicted a ratio less than 1 in the second batch (p = 0.013). Twenty-seven percent had blood stored in the emergency department and 14% in the operating room. Twenty-four percent of MTPs autoactivate and 80% are trauma surgeon activated, 66% by the anesthesia staff, 32% by other surgeons, and 17% by the blood bank. Trauma surgeons activate the MTP most.
Most centers have a MTP. Protocols are variable and new, and half have a 1:1 FFP : RBC ratio. Protocols with fewer initial units of FFP compared to RBCs maintain this.
大量输血方案（MTP）的使用和组成情况尚不清楚。
一项基于网络的调查被发送给东部创伤外科学会的成员，并在美国创伤外科学会的通讯中公布。采用卡方检验和逻辑回归进行比较。
共有 186 名外科医生和 59 名中心主任做出了回应。为避免偏差，仅报告主任的回复。60%的中心每年收治超过 1500 名患者。67%的中心有院内主治医生值班，85%的中心有 MTP。机构规模、级别、住院医师身份或住院人数均不能预测 MTP 的存在。65%的 MTP 建立不到 5 年，其中 18%不到 1 年。设计方案各不相同：23%的 MTP 只有一批成分，25%的 MTP 有两批或三批，41%的 MTP 有三批以上，11%的 MTP 不使用批次。第一批中只有 62%含有新鲜冷冻血浆（FFP）。第二批中 98%含有 FFP。第三批所有箱子都含有 FFP。第一批中 FFP 与红细胞（RBC）的比例小于 1，预测第二批中 FFP 与 RBC 的比例也小于 1（p=0.013）。27%的中心将血液储存在急诊室，14%的中心将血液储存在手术室。24%的 MTP 自动激活，80%由创伤外科医生激活，66%由麻醉科工作人员激活，32%由其他外科医生激活，17%由血库激活。创伤外科医生最常激活 MTP。
大多数中心都有 MTP。方案各不相同且新颖，其中一半的 MTP 中 FFP 与 RBC 的比例为 1:1。与 RBC 相比，初始单位 FFP 较少的方案维持这一比例。
