단일 상급종합병원에서 증례를 중심으로 본 대량수혈 현황

Abstract

Background:Massive transfusion (MT) is an unusual event and has been defined as replacement of total body fluid volume in less 24 hours or transfusion of 10 or more RBC units in 24 hours. MT is a high priority treatment for major blood loss.Methods:We gathered 78 patients receiving MT from 2008 to 2013 at Severance hospital using electronic medical records and performed a retrospective review. For each case, we analyzed patients’ characteristics, including sex, age, major causes of MT, and clinical outcome. We also calculated the ratio of each blood component transfused.Results:Patient sex ratio of male and female was 1.60 and percentage of patients over age 40 was 58.4%. The individual diagnostic categories were 28.2% of cardiovascular surgery, 26.9% of liver transplantation, 11.5% of upper gastrointestinal bleeding, and 5.2% of trauma. The overall mortality rate was 47.3%. Mortality rate ranged from the lowest (52.3%) for liver transplantation to the highest (77.8%) for upper gastrointestinal tract bleeding. No correlation was observed between causes of MT and mortality rate. The average usage of FFP: RBC and platelet: RBC ratio was 0.83 and 0.68, respectively. However, recently, the ratio of two components transfused is close to 1.0.Conclusion:The highest priority in MT was rapidity and propriety for improvement of patient survival. By regularly reviewing MT cases, we could provide an improved massive transfusion service.