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Chapter-04 Massive Transfusion Protocol—What, How, and How Much?

BOOK TITLE: Manual of Postpartum Hemorrhage and High-Risk Pregnancy

Author
1. Mahapatra Smita
ISBN
9789352703708
DOI
10.5005/jp/books/18024_5
Edition
1/e
Publishing Year
2018
Pages
3
Author Affiliations
1. Cuttack, Odisha, India
Chapter keywords
Massive transfusion protocol, MTP, blood transfusion, RBC, Rhesus system, blood type testing, arterial blood gas, ABG, obstetric hemorrhage

Abstract

Massive transfusion protocol (MTP) describes the process of management of blood transfusion requirements in major bleeding episodes, assisting the interactions of the treating clinicians and the blood bank, and ensuring judicious use of blood and blood components. MTP is the administration of 8–10 RBC units to an adult patient in less than 24 hours or as the acute administration of 4–5 RBC units in 1 hour. For patients identified as “low-risk” for transfusion, blood type testing for ABO system and Rhesus system only to be recommended. Massive transfusion protocol should be immediately started in patients with active bleeding after 1–2 liters of blood loss aiming to reduce the maternal morbidity and mortality of the patient. The timing of initial transfusion of MTP ranges from 2–24 hours postdelivery.

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