{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:20:48Z","timestamp":1787016048825,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,12,13]],"date-time":"2017-12-13T00:00:00Z","timestamp":1513123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Massive transfusion is a response to massive uncontrolled hemorrhage. To be effective, it must be timely and address the patient's needs for blood volume, oxygen transport, and hemostasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN AND METHODS<\/jats:title>\n                    <jats:p>A review was performed on all activations of the massive transfusion protocol (MTP) in a hospital with large emergency medicine, trauma, and vascular surgery programs. Indications, transfused amounts, and outcomes were determined for each MTP event to determine appropriateness of MTP use. Results are presented as descriptive statistics, categorical associations, and simple linear trend relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The MTP was activated 309 times in 2016. Of these episodes, 237 were for trauma, 29 for gastrointestinal bleeding, 16 for ruptured abdominal aortic aneurisms, and 25 for a variety of other causes. Trauma\u2010related MTP activations had a mean injury severity score of 32. Blood use averaged 6.6 units of red blood cells (RBCs), 6.5 units of plasma, and 1.2 units of apheresis platelets. Fourteen activations ended without the administration of any blood products, and 45 (14%) did not meet the critical administration threshold of three components. Only 60 (19%) activations met the historic definition of massive with at least 10 units of RBCs administered. Mortality was 15% for the trauma\u2010related activations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Massive transfusion protocol activations were frequent and conducted with high fidelity to the 1:1:1 unit ratio standard. Making blood components available quickly was associated with low rates of total component usage and low mortality for trauma patients and was not associated with overuse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.14443","type":"journal-article","created":{"date-parts":[[2017,12,13]],"date-time":"2017-12-13T23:11:25Z","timestamp":1513206685000},"page":"480-484","source":"Crossref","is-referenced-by-count":37,"title":["Quality management of a massive transfusion protocol"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8596-4420","authenticated-orcid":false,"given":"John R.","family":"Hess","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine University of Washington Seattle Washington"},{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Office of the Medical Director Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina E.","family":"Sen","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia G.","family":"Cruz\u2010Cody","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E.","family":"Tuott","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max J.","family":"Louzon","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen M.","family":"Bulger","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman","family":"Arbabi","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica B.","family":"Pagano","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine University of Washington Seattle Washington"},{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"Metcalf","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine University of Washington Seattle Washington"},{"name":"Transfusion Service Harborview Medical Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001333"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.03050.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182410a3c"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318185fa9f"},{"key":"e_1_2_7_6_1","unstructured":"Standards for massive transfusion programs.1st ed.Chicago:American College of Surgeons Trauma Quality Improvement Project;2013."},{"key":"e_1_2_7_7_1","volume-title":"Standards for a patient blood management 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