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Defining ultra-massive transfusion through a systematic review. | LitMetric

Defining ultra-massive transfusion through a systematic review.

Am J Surg

Grady Health System, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA; Emory University Rollins School of Public Health, Atlanta, GA, USA. Electronic address:

Published: September 2023

Background: Despite the widespread use of ultra-massive transfusion (UMT) as an intervention for trauma patients in hemorrhagic shock, no standard definition exists. We performed a systematic review to determine a consensus definition for UMT.

Methods: A search was performed from 1979 to 2022. The authors screened studies defining UMT and associated outcomes as defined by our prespecified PICO questions. The PRISMA guidelines were used.

Results: 1662 articles met criteria for eligibility assessment, 17 for full-text review and eight for data extraction. Only two studies demonstrated a consensus definition of UMT, which used ≥20 units of red blood cell product within 24hrs. Parameters associated with increased mortality included lower blood pressure, lower pulse and lower Glasgow Coma Score at the time of presentation and a higher injury severity score and undergoing a resuscitative thoracotomy.

Conclusions: The absence of a consensus definition for UMT raises challenges from clinical, research and ethical perspectives. Based on our findings, the authors advocate for the feasibility of standardizing the definition of UMT as ≥20 units of red blood cell product within 24hrs.

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Source
http://dx.doi.org/10.1016/j.amjsurg.2023.09.024DOI Listing

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