Treml Angela B, Gorlin Jed B, Dutton Richard P, Scavone Barbara M
From the *Department of Pathology, the University of Chicago Medicine, Chicago, Illinois; †Memorial Blood Centers, St. Paul, Minnesota; ‡US Anesthesia Partners, Dallas, Texas; and §Department of Anesthesiology, the University of Chicago Medicine, Chicago, Illinois.
Anesth Analg. 2017 Jan;124(1):277-281. doi: 10.1213/ANE.0000000000001610.
Massive transfusion protocols (MTPs) have been adopted in many hospitals, and they may improve outcomes, as well as decrease the number of blood products transfused. However, there are no specific guidelines regarding the number and types of products that should be included in these protocols. MTPs may vary from hospital to hospital.
A short, web-based survey was sent to blood bank medical directors at academic institutions to learn details about MTPs.
A total of 107 survey requests were sent, and 56 were completed (52% response rate). All who responded had an MTP in place. Nearly all (n = 55, 98.2% [95% CI, 90.6%-99.7%]) base their protocol on delivery of fixed amounts and ratios of blood products, with only a minority incorporating any elements of laboratory-directed therapy. The most common target, red blood cell (RBC):plasma ratio, is 1:1 (n = 39, 69.9% [95% CI, 56.7%-80.1%] of respondents). The majority (n = 36, 64.3% [95% CI, 51.2%-75.6%]) provide 6 or more units of red blood cells in the first MTP packet.
One-hundred percent of survey respondents had an MTP in place. Despite a lack of published guidelines regarding MTPs, the survey results demonstrated substantial uniformity in numbers of products and target transfusion ratios.
许多医院已采用大量输血方案（MTP），这些方案可能改善治疗结果，并减少输血的血液制品数量。然而，对于这些方案应包含的制品数量和类型，尚无具体指南。不同医院的MTP可能有所不同。
向学术机构的血库医学主任发送了一份简短的基于网络的调查问卷，以了解MTP的详细信息。
共发出107份调查问卷，56份完成（回复率52%）。所有回复者均已实施MTP。几乎所有回复者（n = 55，98.2%[95%CI，90.6%-99.7%]）的方案基于固定数量和比例的血液制品输注，只有少数方案纳入了实验室指导治疗的任何要素。最常见的目标，即红细胞（RBC）与血浆的比例为1:1（n = 39，占回复者的69.9%[95%CI，56.7%-80.1%]）。大多数回复者（n = 36，64.3%[95%CI，51.2%-75.6%]）在首个MTP包中提供6个或更多单位的红细胞。
100%的调查回复者已实施MTP。尽管缺乏关于MTP的已发表指南，但调查结果显示在制品数量和目标输血比例方面存在很大的一致性。
