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.
10.3346/jkms.2014.29.7.1007
- Author:
Younghwan KIM
1
;
Kiyoung LEE
;
Jihyun KIM
;
Jiyoung KIM
;
Yunjung HEO
;
Heejung WANG
;
Kugjong LEE
;
Kyoungwon JUNG
Author Information
1. Department of Surgery, Ajou University School of Medicine, Suwon, Korea. jake98@daum.net
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Resuscitation;
Transfusion;
Blood Product Ratio;
Survival;
Trauma
- MeSH:
Acute Lung Injury/epidemiology/etiology;
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Bacterial Infections/epidemiology;
*Blood Transfusion/adverse effects;
*Erythrocyte Transfusion/adverse effects;
Female;
Hemorrhage/etiology/*prevention & control;
Hospital Mortality;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Patients;
Respiratory Distress Syndrome, Adult/epidemiology/etiology;
Resuscitation;
Retrospective Studies;
Wounds and Injuries/complications/mortality/*therapy;
Young Adult
- From:Journal of Korean Medical Science
2014;29(7):1007-1011
- CountryRepublic of Korea
- Language:English
-
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 (> or =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.
