Massive transfusions and severe hypocalcemia: An opportunity for monitoring and supplementation guidelines

Background Massive transfusion protocols (MTPs) are associated with severe hypocalcemia, contributing to coagulopathy and mortality in severely injured patients. Severity of hypocalcemia following massive activation appropriate treatment strategies remain undefined. Study design methods This was a retrospective study all MTP activations adult trauma patients at Level 1 center between August 2016 September 2017. Units blood products transfused, ionized calcium levels, amount supplementation administered were recorded. Primary outcomes levels the incidence (iCa ≤1.0 mmol/L) relation volume transfused. Results Seventy-one had an activated during period. The median packed red cells (PRBCs) transfused 10 units (range 1–52). A total 42 (59.1%) periods hypocalcemia. Patients receiving 13 or more PRBC greater prevalence 83.3% having least one measured mmoL/L (p = .001). number checked supplemental given who experienced varied considerably. Discussion Severe commonly occurs correlates Monitoring is widely variable. Standardized for recognition management transfusions may improve outcomes.