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 inJournal of Korean medical science Vol. 29; no. 7; pp. 1007 - 1011
Main Authors Kim, Younghwan, Lee, KiYoung, Kim, Jihyun, Kim, Jiyoung, Heo, Yunjung, Wang, Heejung, Lee, Kugjong, Jung, Kyoungwon
Format Journal Article
LanguageEnglish
Published Korea (South) The Korean Academy of Medical Sciences 01.07.2014
대한의학회
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Online AccessGet full text
ISSN1011-8934
1598-6357
1598-6357
DOI10.3346/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.
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
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Issue 7
Keywords Transfusion
Blood Product Ratio
Survival
Trauma
Resuscitation
Language English
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Snippet When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such...
When treating trauma patients with severe hemorrhage, massive transfusions are oftenneeded. Damage control resuscitation strategies can be used for such...
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SubjectTerms Acute Lung Injury - epidemiology
Acute Lung Injury - etiology
Adolescent
Adult
Aged
Aged, 80 and over
Bacterial Infections - epidemiology
Blood Transfusion
Erythrocyte Transfusion - adverse effects
Female
Hemorrhage - etiology
Hemorrhage - prevention & control
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Original
Patients
Respiratory Distress Syndrome, Adult - epidemiology
Respiratory Distress Syndrome, Adult - etiology
Resuscitation
Retrospective Studies
Transfusion Reaction
Wounds and Injuries - complications
Wounds and Injuries - mortality
Wounds and Injuries - therapy
Young Adult
의학일반
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Title 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
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