From the Guidelines
The benchmark number of units for Mass Transfusion Protocol (MTP) is 10 units of red blood cells in 24 hours.
Key Points
- This definition is based on the European Society of Intensive Care Medicine's clinical practice guideline for transfusion strategies in bleeding critically ill adults 1.
- Other studies also support this definition, including the use of > 6 units in 6 hours as an alternative criterion for massive bleeding 1.
- The definition of massive bleeding is crucial in determining the need for MTP, which involves the early evaluation and correction of trauma-induced coagulopathy 1.
- The use of high-ratio transfusion strategies, such as at least one unit plasma per two units of packed red blood cells, is suggested in critically ill patients with massive bleeding due to trauma 1.
- It is essential to note that the definition of massive bleeding may vary depending on the context and patient population, but 10 units in 24 hours is a commonly accepted benchmark for MTP.
From the Research
Benchmark Number of Units for Mass Transfusion Protocol (MTP)
- The benchmark number of units for MTP is not strictly defined, but studies suggest that most hospitals provide 6 or more units of red blood cells in the first MTP packet 2.
- A study found that the majority of hospitals (64.3%) provide 6 or more units of red blood cells in the first MTP packet, with a common target red blood cell (RBC):plasma ratio of 1:1 2.
- Another study reported that blood use averaged 6.6 units of red blood cells (RBCs), 6.5 units of plasma, and 1.2 units of apheresis platelets for trauma-related MTP activations 3.
- A retrospective cohort study found that patients who received MTP activation received a median of 7 units of blood products, compared to 2 units for patients without MTP criteria 4.
- However, the definition of massive transfusion and the threshold for MTP activation can vary, with some studies using ≥10 units of red blood cells in 24 hours, ≥5 units of RBC in 6 hours, ≥3 units of RBC in 1 hour, or ≥4 units of total products in 30 minutes as criteria 5.