Application of Damage Control Resuscitation Strategies to Patients with Severe Traumatic Hemorrhage: Review of Plasma to Packed Red Blood Cell Ratios at a Single Institution
When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively revie...
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Published in | Journal of Korean medical science Vol. 29; no. 7; pp. 1007 - 1011 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Korea (South)
The Korean Academy of Medical Sciences
01.07.2014
대한의학회 |
Subjects | |
Online Access | Get full text |
ISSN | 1011-8934 1598-6357 1598-6357 |
DOI | 10.3346/jkms.2014.29.7.1007 |
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Abstract | When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (≥0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased. |
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AbstractList | When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (≥0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased. When treating trauma patients with severe hemorrhage, massive transfusions are oftenneeded. Damage control resuscitation strategies can be used for such patients, but anadequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio mustbe established. We retrospectively reviewed the medical records of 100 trauma patientstreated with massive transfusions from March 2010 to October 2012. We divided thepatients into 2 groups according to the FFP:PRBC ratio: a high-ratio (≥ 0.5) and a lowratiogroup (< 0.5). The patient demographics, fluid and transfusion quantities, laboratoryvalues, complications, and outcomes were analyzed and compared. There were 68 patientsin the high-ratio and 32 in the low-ratio group. There were statistically significantdifferences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloidsadministered, as well as the initial diastolic blood pressure. Bloodstream infections werenoted only in the high-ratio group, and the difference was statistically significant (P =0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher inthe high-ratio group (71.9% vs. 97.1%, P < 0.001). In severe hemorrhagic trauma, raisingthe FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts tominimize bloodstream infections during the resuscitation must be increased. KCI Citation Count: 1 When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (≥0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (≥0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased. |
Author | Jung, Kyoungwon Kim, Jihyun Heo, Yunjung Wang, Heejung Lee, Kugjong Kim, Jiyoung Kim, Younghwan Lee, KiYoung |
AuthorAffiliation | 3 Department of Biomedical Sciences, Graduate School, Ajou University School of Medicine, Suwon, Korea 2 Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea 1 Department of Surgery, Ajou University School of Medicine, Suwon, Korea 4 Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Korea |
AuthorAffiliation_xml | – name: 2 Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea – name: 4 Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Korea – name: 3 Department of Biomedical Sciences, Graduate School, Ajou University School of Medicine, Suwon, Korea – name: 1 Department of Surgery, Ajou University School of Medicine, Suwon, Korea |
Author_xml | – sequence: 1 givenname: Younghwan orcidid: 0000-0003-3836-8743 surname: Kim fullname: Kim, Younghwan organization: Department of Surgery, Ajou University School of Medicine, Suwon, Korea – sequence: 2 givenname: KiYoung orcidid: 0000-0003-3720-6574 surname: Lee fullname: Lee, KiYoung organization: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea., Department of Biomedical Sciences, Graduate School, Ajou University School of Medicine, Suwon, Korea – sequence: 3 givenname: Jihyun orcidid: 0000-0002-2639-1594 surname: Kim fullname: Kim, Jihyun organization: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea., Department of Biomedical Sciences, Graduate School, Ajou University School of Medicine, Suwon, Korea – sequence: 4 givenname: Jiyoung orcidid: 0000-0003-4813-1096 surname: Kim fullname: Kim, Jiyoung organization: Department of Surgery, Ajou University School of Medicine, Suwon, Korea – sequence: 5 givenname: Yunjung orcidid: 0000-0001-5708-1428 surname: Heo fullname: Heo, Yunjung organization: Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Korea – sequence: 6 givenname: Heejung orcidid: 0000-0002-0687-007X surname: Wang fullname: Wang, Heejung organization: Department of Surgery, Ajou University School of Medicine, Suwon, Korea – sequence: 7 givenname: Kugjong orcidid: 0000-0002-5468-3340 surname: Lee fullname: Lee, Kugjong organization: Department of Surgery, Ajou University School of Medicine, Suwon, Korea – sequence: 8 givenname: Kyoungwon orcidid: 0000-0001-7895-0362 surname: Jung fullname: Jung, Kyoungwon organization: Department of Surgery, Ajou University School of Medicine, Suwon, Korea |
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