The efficacy of Massive Transfusion Protocol / whole blood transfusion: An umbrella review

Introduction: Although massive transfusion protocol (MTP) has been used extensively in the treatment of patients with bleeding trauma, its actual efficacy remains unknown. This umbrella review of systematic reviews and meta-analyses aims to update the evidence and assess the impact of implementing MTP/ whole blood transfusion on the mortality of trauma patients.Methods: Data sources: This umbrella review searched Medline (via Ovid), Embase, PubMed, Cochrane Library, CINAHL databases, JBISRIR, Epistemonikos, EPPI-Centre, CRD, and PROSPERO for possible systematic reviews from inception until October 2023.  Study eligibility criteria, participants, and interventions: Reviews that reported data comparing different types of massive blood perfusion were included. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool. Our study outcomes, 30-day mortality, and 24-hour mortality, were re-analyzed using Comprehensive Meta-Analysis Software (CMA 3.0).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 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.Conclusion: Our results support that MTP decreases 30-day mortality compared to non-MTP. Furthermore, our analysis showed that whole blood transfusion decreases the odds of 24-hour mortality compared to blood components.

The efficacy of Massive Transfusion Protocol / whole blood transfusion: An umbrella review Keywords:

Massive blood transfusion , Trauma , Systematic review