ibcc massive transfusion protocol
- resuscitate first before intubate to avoid hemodynamic collapse
- 1:1:1 ratio is pRBC, plt, FFP
- target fibrinogen > 100
- TXA can be beneficial in massive transfusion
- avoid acedemia and hypothermia in transfusion
- target low normal MAP 60 to avoid bleeding
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Hypocalcemia Is Common Abnormality After Massive Transfusion
hypocalcemia is common abnormality after massive transfusion
- blood products have citrate preservative that binds to endogenous calcium after transfusion, leading to hypocalcemia
- hypocalcemia can cause coagulopathy
- don't wait for hypocalcemia on labs. Aim for mildly elevated calcium levels in massive transfusion