| 'Blind' transfusion of blood products in exsanguinating trauma patients. | |
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MedLine Citation:
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PMID: 17292528 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In trauma, as interventions are carried out to stop bleeding, ongoing resuscitation with blood products is of vital importance. As transfusion policy in exsanguinating patients cannot be based on laboratory tests, transfusion of blood products is performed empirically or 'blindly'. The aim of this study was to delineate 'blind' transfusion practice in the hectic clinical situation of exsanguination. METHODS: Seventeen trauma patients were selected who died due to uncontrolled bleeding despite haemostatic interventions within 24h after admission and who received more than 12 U of RBC. Transfusion data were compared with a theoretically optimal transfusion model with a fixed ratio between units of RBC, FFP, and platelets. The difference between the observed and expected amounts of blood products was calculated. RESULTS: The patients (82%) received insufficient amounts of FFP and platelets when compared to the calculated amounts. The total numbers of transfused FFP and platelets were on average 50% lower than the calculated amounts. Regression models showed an increase of FFP and platelets with increasing amounts of RBC but not in sufficient quantities. CONCLUSION: Exsanguinating trauma patients receiving massive transfusions are subject to 'blind' transfusion. This is associated with insufficient transfusion of both FFP and platelets, which may aggravate bleeding. A 'blind' transfusion strategy consisting of a validated guideline with a predefined ratio of the different blood products, timing of laboratory tests as well as a sound logistic protocol facilitating this procedure, involving the blood bank and treating physicians, is needed urgently. |
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Authors:
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L M G Geeraedts; H Demiral; N P Schaap; P W Kamphuisen; J C Pompe; J P M Frölke |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2007-02-09 |
Journal Detail:
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Title: Resuscitation Volume: 73 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-05-21 Completed Date: 2007-08-17 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 382-8 Citation Subset: IM |
Affiliation:
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Department of Surgery, Section Traumatology, University Medical Centre, Nijmegen, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Erythrocyte Transfusion / utilization* Fatal Outcome Female Hemorrhage / etiology, therapy* Humans Male Multiple Trauma / complications* Platelet Transfusion / utilization* |
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