Tunis Med. 2022;100(2):149-155.
Massive transfusion (MT) is a life-saving therapy in situations of major hemorrhage awaiting radical haemostatic treatment. Poor management and control of this therapy may, however, compromise the patient's vital prognosis. The main aim of our study was to take stock of massive transfusion practices in Tunisia. The secondary aim was to propose a massive transfusion protocol.
An analytical observational study based on a questionnaire was conducted. We targeted physicians brought in their clinical practice to use MT.
A total of 124 clinicians responded to the questionnaire. The majority (62%) were anesthesiologists or emergency physicians. More than half of the participants were residents (51%). The use of MT based on a clinical or biological score was only found for a minority (13%). The initial order was for the majority of participants (N=69) made up of red blood cell concentrates (RBC) and fresh frozen plasma (FFP). The FFP: RBC ratio was1:2 for 51% of the participants. A higher ratio was adopted by the rest. Respectively 23.5% and 9.6% of participants transfused platelets and fibrinogen concentrates without waiting for the result of biology. The use of tranexamic acid was systematically advocated by 60.5% of clinicians. The majority (86.3%) adopted a restrictive transfusion strategy (target hemoglobin between 7 and 9 g/dl). The latter was more adopted by the youngest physicians (92.1% of residents versus 55.6% of professors; p=0.008).
The professional practices of MT in Tunisia are heterogeneous. Given the lack of a clear institutionalized procedure which frames this therapy, a MT protocol has thus been proposed.
大量输血（MT）是在等待根治性止血治疗的大出血情况下的救命疗法。然而，如果这种治疗的管理和控制不善，可能会危及患者的生命预后。我们研究的主要目的是了解突尼斯大量输血的实践情况。次要目的是提出一个大量输血方案。
我们进行了一项基于问卷的分析性观察研究。我们的目标是在临床实践中使用 MT 的医生。
共有 124 名临床医生回答了问卷。大多数（62%）是麻醉师或急诊医生。超过一半的参与者是住院医师（51%）。只有少数人（13%）根据临床或生物学评分使用 MT。对于大多数参与者（N=69），初始命令是由红细胞浓缩物（RBC）和新鲜冷冻血浆（FFP）组成。51%的参与者采用的 FFP：RBC 比值为 1:2。其余的则采用更高的比值。分别有 23.5%和 9.6%的参与者在等待生物学结果之前输注血小板和纤维蛋白原浓缩物。60.5%的临床医生系统地主张使用氨甲环酸。大多数（86.3%）采用限制输血策略（目标血红蛋白为 7 至 9 g/dl）。年轻的医生更倾向于采用这种策略（92.1%的住院医师与 55.6%的教授相比；p=0.008）。
突尼斯 MT 的专业实践存在异质性。由于缺乏明确的制度化程序来规范这种治疗，因此提出了一个 MT 方案。
