Base Deficit, Coagulopathy, and Hemoperitoneum Predict Need for Massive Transfusion

Early hemostatic or “damage control” resuscitation with blood products has been shown to improve outcomes in severely injured patients, yet the indications used for initiation of blood products vary. Researchers retrospectively reviewed an Australia trauma registry to determine independent predictors of significant hemorrhage and need for massive transfusion. They identified 1546 adult trauma patients who required transfusion of at least 1 unit of packed red cells during resuscitation, and compared 935 patients who received massive transfusion (≥10 units of packed red blood cells within 24 hours) with 611 who received <10 units within 24 hours.

Independent predictors of massive transfusion were base deficit >5 on presentation (odds ratio, 1.…