Massive transfusions for critical bleeding: Is everything old new again?

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Massive transfusion or major haemorrhage protocols have been widely adopted in the treatment of critically bleeding patients. Following evidence that higher ratios of transfused plasma and platelets to red blood cells may offer survival benefits in military trauma patients, these ratios are now commonly incorporated into massive transfusion protocols. They more closely resemble the effects of whole blood transfusion, which in the second half of last century was largely replaced by individual blood component transfusion based on laboratory-guided indicators. However, high-quality evidence to guide transfusion support for critically bleeding patients across the range of bleeding contexts is lacking, including for both trauma and non-trauma patients. More data on major haemorrhage support and clinical outcomes are needed to inform guidelines and practice.

Original languageEnglish
Pages (from-to)140-149
Number of pages10
JournalTransfusion Medicine
Issue number2
Publication statusPublished - Apr 2018


  • Critical bleeding
  • Fibrinogen
  • Haemorrhage
  • Massive transfusion

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