Coagulation defects associated with massive blood transfusion: A large multicenter study

Yang,Jiang‑Cun; Sun,Yang; Xu,Cui‑Xiang; Dang,Qian‑Li; Li,Ling; Xu,Yong‑Gang; Song,Yao‑Jun; Yan,Hong

doi:10.3892/mmr.2015.3971

Coagulation defects associated with massive blood transfusion: A large multicenter study

Authors:
- Jiang‑Cun Yang
- Yang Sun
- Cui‑Xiang Xu
- Qian‑Li Dang
- Ling Li
- Yong‑Gang Xu
- Yao‑Jun Song
- Hong Yan
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Affiliations: Department of Transfusion Medicine, The Third Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China, Shaanxi Provincial Center for Clinical Laboratory, The Third Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China, Department of Dermatology, The Third Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China, Department of Laboratory, The Third Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China, Department of Urology, The Third Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China, Department of Epidemiology and Health Statistics, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
Published online on: June 22, 2015 https://doi.org/10.3892/mmr.2015.3971
Pages: 4179-4186
Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].

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Abstract

The variations in the coagulation indices of patients receiving massive blood transfusion were investigated across 20 large‑scale general hospitals in China. The data of 1,601 surgical inpatients receiving massive transfusion were retrospectively collected and the trends in the platelet counts and coagulation indices prior to and at 16 different time points during packed red blood cell (pRBC; after 2‑40 units of pRBC) transfusion were evaluated by linear regression analysis. Temporal variations in the means of prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) and fibrinogen (FIB) concentration were also assessed and the theoretical estimates and actual measurements of the platelet count were compared. The results demonstrated that the platelet count decreased linearly with an increase in the number of pRBC units transfused (Y=150.460‑3.041X; R2 linear=0.775). Following transfusion of 18 units of pRBC (0.3 units of pRBC transfused per kilogram of body weight), the average platelet count decreased to 71x109/l (<75x109/l). Furthermore, variations in the means of PT, INR, APTT and FIB did not demonstrate any pronounced trends and actual platelet counts were markedly higher than the theoretical estimates. In conclusion, no variations in the means of traditional coagulation indices were identified, however, the platelet count demonstrated a significant linear decrease with an increase in the number of pRBC units transfused. Furthermore, actual platelet counts were higher than theoretical estimates, indicating the requirement for close monitoring of actual platelet counts during massive pRBC transfusion.

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