A Simple Comment of Trauma-Induced Coagulopathy and Massive Transfusion

Abstract

A massive blood transfusion is a challenging situation that can be encountered in the treatment of trauma patients. Under these circumstances, clinicians should conduct appropriate blood transfusions using the massive transfusion protocol, and make efforts to prepare and apply these protocols to the systems of each hospital in advance. In addition, the effect of massive bleeding on the body highlights the need to understand why fresh frozen plasma and platelets, as well as packed red blood cells (pRBC), are needed during massive transfusion. In hemorrhagic patients, blood pressure maintenance through transfusion is an important part, but above all, efforts to control sustained bleeding by controlling and treating the bleeding itself are more important. This is because patients need to recover their organs after early resuscitation by minimizing the side effects of transfusion. No research has been done to compare the restrictive transfusion and liberal transfusion strategies in patients requiring massive transfusion. On the other hand, various studies suggest that it is more advantageous to apply a liberal blood transfusion strategy in patients with severe or older age. Nevertheless, there has been insufficient research to apply it generally. Therefore, for patients whose resuscitation has been performed by applying a massive transfusion protocol, a reasonable treatment approach would be to shift to a strategy to supplement poor coagulation factors through a goal-directed transfusion. (Korean J Blood Transfus 2020;31:101-108)