Document Detail


Is there a role for aggressive use of fresh frozen plasma in massive transfusion of civilian trauma patients?
MedLine Citation:
PMID:  19095115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Damage control resuscitation (DCR) with early plasma in combat casualties requiring massive transfusion (MT) decreases early deaths from bleeding. METHODS: To ascertain the potential role of early plasma DCR in civilian MT, we queried a prospective traumatic shock database of 383 civilians. RESULTS: Ninety-three (24%) of the traumatic shock civilians received a MT, of which 26 (28%) died early, predominantly from bleeding within 6 hours. Comparatively, this early MT death cohort arrived in more severe shock and were coagulopathic (mean INR 2.4). In the critical period of MT (ie, the first 3 hours), these patients received 20 U of packed red blood cells (PRBCs) but only 4 U of fresh frozen plasma (FFP). They remained severely acidotic and their coagulopathy worsened as they exsanquinated. CONCLUSION: Civilians who arrived in traumatic shock, required a MT, and died early had worsening coagulopathy, which was not treated. DCR with FFP may have a role in civilian trauma.
Authors:
Frederick A Moore; Teresa Nelson; Bruce A McKinley; Ernest E Moore; Avery B Nathens; Peter Rhee; Juan Carlos Puyana; Gregory J Beilman; Stephen M Cohn;
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  196     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-19     Completed Date:  2009-01-06     Revised Date:  2009-05-20    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  948-58; discussion 958-60     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, The Methodist Hospital, Houston, TX, USA. famoore@tmh.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Blood Component Transfusion / methods*
Critical Care / methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Plasma
Prospective Studies
Time Factors
Trauma Severity Indices
Treatment Outcome
Wounds and Injuries / diagnosis,  therapy*
Young Adult
Investigator
Investigator/Affiliation:
Janet McCarthy / ; Rachelle Babbitt Jonas / ; Joseph Johnston / ; Peter Lopez / ; Dian Nuxoll / ; Huawei Tang / ; Burapat Sangthong / ; Constantinos Constantinou / ; Patricio Polanco / ; Andrew B Peitzman / ; Stephanie Huls / ; Jeffrey L Johnson / ; Catherine C Cothren / ; Melissa Thorson / ; Alan Beal / ; Ronald G Pearl / ; Larry M Gentilello / ; Anthony A Meyer / ; Leann Anderson / ; Barbara Gallea / ; Diane Rupp / ; Becky Saar / ; Michelle McGraw / ; Virginia Diaz / ; Kristi Carlson / ; Greg Wheatley /

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


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