MASSIVE TRANSFUSION PROTOCOL IN ABDOMINAL TRAUMA: AN ANALYSIS OF THE 2026 GUIDELINES

Abdominal trauma with exsanguinating hemorrhage represents a critical challenge for emergency medicine, requiring immediate interventions to contain the lethal triad. This study consisted of an integrative literature review, based on databases such as PubMed, SciELO, and LILACS, focusing on massive transfusion protocols updated through 2026. The results indicate that the early activation of protocols based on a 1:1:1 hemostatic ratio of red blood cells, plasma, and platelets significantly reduces early mortality. The discussion highlights that the implementation of rotational thromboelastometry and rigorous control of citrate-induced hypocalcemia allow for a more precise and less deleterious therapy. It is concluded that modern management of traumatic hemorrhagic shock must integrate permissive hypotension and the timely use of tranexamic acid, prioritizing hemostatic resuscitation over crystalloid volume replacement to ensure the viability of the critical patient.