Document Detail


Emergency department blood transfusion predicts early massive transfusion and early blood component requirement.
MedLine Citation:
PMID:  20456707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to evaluate the ability of uncrossmatched transfusions in the emergency department (ED) to predict early (< 6 hr) massive transfusion (MT) of red blood cells (RBCs) and blood components.
STUDY DESIGN AND METHODS: All patients admitted to a Level 1 trauma center between July 2005 and June 2007 who received any transfusions and were transported directly from the scene of injury were included. Early MT was defined as the need for 10 U or more or RBCs in the first 6 hours. Early MT plasma was defined as 6 U or more of plasma in the first 6 hours. Early MT platelets (PLTs) were defined as two or more apheresis transfusions in the first 6 hours. Univariate and multivariate analyses were performed.
RESULTS: A total of 485 patients (34%) received ED transfusions (ED RBC+) and 956 (66%) did not receive ED transfusions (ED RBC-). ED RBC+ patients were younger, were more likely to be male, and arrived with more severe injuries. Multivariate regression identified ED transfusion of uncrossmatched RBC as an independent predictor of requiring early MT of RBCs (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.36-7.59; p = 0.001), plasma (OR, 2.7; 95% CI, 1.66-4.39; p < 0.001), and PLTs (OR, 1.9; 95% CI, 1.08-3.41; p = 0.025).
CONCLUSION: Patients receiving uncrossmatched RBCs in the ED are more than three times more likely to receive early MT of RBCs. Additionally, patients transfused with ED RBCs are more likely to receive 6 units or more of plasma and two or more apheresis PLT transfusions. Given these findings, ED transfusion of uncrossmatched RBCs should be considered a potential trigger for activation of an institution's MT protocol.
Authors:
Timothy C Nunez; William D Dutton; Addison K May; John B Holcomb; Pampee P Young; Bryan A Cotton
Related Documents :
951737 - The maximum surgical blood order schedule and surgical blood use in the united states.
10749637 - Use of the surgical blood order equation in spinal instrumentation and fusion surgery.
20425957 - Understanding blood groups and transfusion in nursing practice.
15596927 - Medical staff attitudes: views and positions regarding blood transfusion to terminally ...
2505157 - Hemodynamic assessment of the spinal cord arteriovenous malformation with intraoperativ...
9745097 - Clinical usefulness of flow cytometry in detection and quantification of fetomaternal h...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  50     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-05     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1914-20     Citation Subset:  IM    
Copyright Information:
© 2010 American Association of Blood Banks.
Affiliation:
Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Blood Component Transfusion / statistics & numerical data*
Blood Transfusion / statistics & numerical data*
Erythrocyte Transfusion / statistics & numerical data
Female
Humans
Injury Severity Score
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Trauma Centers / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Obtaining of CD34+ cells from healthy blood donors: development of a rapid and efficient procedure u...
Next Document:  In vitro cell quality of buffy coat platelets in additive solution treated with pathogen reduction t...