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Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time

OBJECTIVE: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). METHODS: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all a...

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Autores principales: Peralta, Ruben, Vijay, Adarsh, El-Menyar, Ayman, Consunji, Rafael, Abdelrahman, Husham, Parchani, Ashok, Afifi, Ibrahim, Zarour, Ahmad, Al-Thani, Hassan, Latifi, Rifat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536606/
https://www.ncbi.nlm.nih.gov/pubmed/26279672
http://dx.doi.org/10.1186/s13017-015-0028-3
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author Peralta, Ruben
Vijay, Adarsh
El-Menyar, Ayman
Consunji, Rafael
Abdelrahman, Husham
Parchani, Ashok
Afifi, Ibrahim
Zarour, Ahmad
Al-Thani, Hassan
Latifi, Rifat
author_facet Peralta, Ruben
Vijay, Adarsh
El-Menyar, Ayman
Consunji, Rafael
Abdelrahman, Husham
Parchani, Ashok
Afifi, Ibrahim
Zarour, Ahmad
Al-Thani, Hassan
Latifi, Rifat
author_sort Peralta, Ruben
collection PubMed
description OBJECTIVE: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). METHODS: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10 units) of packed red blood cell (PRBC) during the initial 24 h post traumatic injury. Data were analyzed with respect to FFB:PRBC ratio [(high ≥ 1:1.5) (HMTP) vs. (low < 1:1.5) (LMTP)] given at the first 4 h post-injury and also between (>4 and 24 h). Mortality, multiorgan failure (MOF) and infectious complications were studied as well. RESULTS: During the study period, a total of 4864 trauma patients were admitted to the hospital, 1.6 % (n = 77) of them met the inclusion criteria. Both groups were comparable with respect to initial pH, international normalized ratio, injury severity score, revised trauma score and development of infectious complications. However, HMTP was associated with lower crude mortality (41.9 vs. 78.3 %, p = 0.001) and lower rate of MOF (48.4 vs. 87.0 %, p = 0.001). The number of deaths was 3 times higher in LMTP in comparison to HMTP within the first 30 days (36 vs. 13 cases). The majority of deaths occurred within the first 24 h (80.5 % in LMTP and 69 % in HMTP) and particularly within the first 6 h (55 vs. 46 %). CONCLUSIONS: Aggressive attainment of high FFP/PRBC ratios as early as 4 h post-injury can substantially improve outcomes in trauma patients.
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spelling pubmed-45366062015-08-15 Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time Peralta, Ruben Vijay, Adarsh El-Menyar, Ayman Consunji, Rafael Abdelrahman, Husham Parchani, Ashok Afifi, Ibrahim Zarour, Ahmad Al-Thani, Hassan Latifi, Rifat World J Emerg Surg Research Article OBJECTIVE: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). METHODS: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10 units) of packed red blood cell (PRBC) during the initial 24 h post traumatic injury. Data were analyzed with respect to FFB:PRBC ratio [(high ≥ 1:1.5) (HMTP) vs. (low < 1:1.5) (LMTP)] given at the first 4 h post-injury and also between (>4 and 24 h). Mortality, multiorgan failure (MOF) and infectious complications were studied as well. RESULTS: During the study period, a total of 4864 trauma patients were admitted to the hospital, 1.6 % (n = 77) of them met the inclusion criteria. Both groups were comparable with respect to initial pH, international normalized ratio, injury severity score, revised trauma score and development of infectious complications. However, HMTP was associated with lower crude mortality (41.9 vs. 78.3 %, p = 0.001) and lower rate of MOF (48.4 vs. 87.0 %, p = 0.001). The number of deaths was 3 times higher in LMTP in comparison to HMTP within the first 30 days (36 vs. 13 cases). The majority of deaths occurred within the first 24 h (80.5 % in LMTP and 69 % in HMTP) and particularly within the first 6 h (55 vs. 46 %). CONCLUSIONS: Aggressive attainment of high FFP/PRBC ratios as early as 4 h post-injury can substantially improve outcomes in trauma patients. BioMed Central 2015-08-14 /pmc/articles/PMC4536606/ /pubmed/26279672 http://dx.doi.org/10.1186/s13017-015-0028-3 Text en © Peralta et al. 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Peralta, Ruben
Vijay, Adarsh
El-Menyar, Ayman
Consunji, Rafael
Abdelrahman, Husham
Parchani, Ashok
Afifi, Ibrahim
Zarour, Ahmad
Al-Thani, Hassan
Latifi, Rifat
Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
title Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
title_full Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
title_fullStr Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
title_full_unstemmed Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
title_short Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
title_sort trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536606/
https://www.ncbi.nlm.nih.gov/pubmed/26279672
http://dx.doi.org/10.1186/s13017-015-0028-3
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