creation date: 2026-04-06 00:15
tags: Interventions
Massive Transfusion Protocol
Overview
Massive transfusion refers to either:
- Replacement of >1 blood volume in 24 hours
-
50% of blood volume in 4 hours (approximately 70 mL/kg in adult)
- Transfusion of >40 mL/kg in children
Massive transfusion protocol is used when a patient is critically bleeding in anticipation of requiring massive transfusion.
Protocol
Transfusion
The transfusion protocol will vary based on institution and are typically standardized.
Monitoring
The following parameters are checked every 30-60 minutes during a massive transfusion.
| Parameters | Values to aim for |
|---|---|
| MAP | 60-65 (or SBP 80-90) for penetrating trauma; ≥85 (SBP >120) for blunt trauma |
| Fibrinogen | 1.5-2 g/L |
| Platelet | >50,000/mcL |
| pH | 7.35-7.45 |
| Temperature | >35 C |
| O2 saturation | >94% |
| Urine output | >0.5 mL/kg/h |
| Serum lactate | <2 mmol/L |
Complications
Complications are discussed separately.