Resumen

BERRO, Maximiliano. Massive transfusion update. Rev. Méd. Urug. [online]. 2023, vol.39, n.2, e401.  Epub 01-Jun-2023. ISSN 0303-3295.  https://doi.org/1688-0390-rmu-39-2-e401.

Massive transfusion poses clinical, organizational and logistic challenges for the health staff in general, and the Transfusion Medicine Services in particular. There is no universally accepted definition for massive transfusion, the most widely used being based on the number of blood units administered in a certain period of time. Most massive transfusion events occur in the context of severe hemorrhage on surgical or multiple-trauma patients or patients with gastrointestinal or obstetric bleeding. Today, damage control resuscitation and massive transfusion protocols are the most common strategies for initial treatment, followed by personalized therapy, goal-directed, my means of monitoring coagulation in real time with viscoelastic studies. There are disputes as to the best surgical treatment, including using whole blood, the relation of blood components to be used, the use of coagulation factor concentrates and the optimal indication of tranexamic acid. The study of ideal products to treat patients with massive hemorrhage has become an area of great interest for scientific research. The clinical context of the hemorrhagic event, the number of blood components transfused, patient's age and comorbilities are the most important predictors for survival in the short and long term. This narrative review explores the current state of affairs on knowledge about massive transfusion, as well as progress to be expected in the near future.

Palabras clave : Massive transfusion; Massive hemorrhage; Massive transfusion protocol; Damage control resuscitation; Hemostatic resuscitation; Whole blood; Blood components; Blood products.

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