Massive Transfusion Protocol in hemorrhagic shock patients (Traumatic and non-traumatic): Umbrella Review

Abstract

Massive blood transfusions have many complications in trauma and non-trauma patients, and determining the optimal ratio of blood products is also discussed in different studies. We conducted an umbrella review of previous review studies, by reviewing and summarizing the studies, we tried to better identify the patients who need massive blood transfusions in order to provide better measures in the management of these cases. Methods: In this study, we searched the databases until October, 2023. Reviews that reported the data for comparison of different types of massive blood perfusion were included. The quality of studies was evaluated by Joanna Briggs Institute (JBI) critical appraisal tool. Results: Thirty studies met the eligibility criteria. Eventually, we included eight studies in the current meta-analysis. The calculated odds ratio (OR) and 95% confidence interval (CI) for 30-day mortality in massive transfusion protocol (MTP) and non-MTP comparison was OR = 0.654, 95% CI 0.576, 0.741, P-value <0.001, and similarly, when comparing the whole blood group and blood component group, significant differences were found between the groups in terms of 24h-mortality 0.763, (95% CI 0.608, 0.957), and P-value = 0.020. The results showed low heterogeneity among the studies