1.
Effect of Early Equal-Proportional Infusion of Plasma and Red Blood Cells on the Prognosis of Emergency Patients with Traumatic Hemorrhage
Fan, Y., Ye, Z., Tang, Y.
Clinical laboratory. 2023;69(7)
Abstract
BACKGROUND The goal was to study the effect of early equal-proportion transfusion on the prognosis of trauma patients with bleeding. METHODS Emergency hospital trauma patients were randomly divided into two groups, a group based on assessment of blood consumption (ABC) to assess whether need to start the massive blood transfusion patients, such as proportion of blood transfusion (fresh frozen plasma: suspended red blood cells = 1:1), and the other group using traditional methods of blood transfusion, namely according to routine blood and clotting function and hemodynamic parameters, to decide when and what blood constituents should be transfused. RESULTS The coagulation got better in the early equal-proportion transfusion group, there were significant differences of PT and APTT (p < 0.05). The amount of 24 hours RBC and plasma transfusion was decreased in the early equal-proportion transfusion group, compared to the control group (p < 0.05), the length of ICU stay was shortened, the 24-hours SOFA score was improved, and there was no significant difference in 24-hours mortality, in-hospital mortality and total length of in-hospital stay (p > 0.05). CONCLUSIONS Early transfusion can reduce the total amount of blood transfusion and shorten ICU time, but has no significant effect on mortality.
3.
A novel intravenous catheter with self-operating pretransfusion blood sampling for enhanced transfusion safety: retrospective risk analysis and prospective phase II trial in emergency care
Notter M, Storch A, Richter-Loeseke E, Arntz H-R, Fakler J, Thiel E, Lahmer-Naim E, Pfaff A, Breckwoldt J
Blood. 2008;112((11):): Abstract No. 3046.
4.
The rapid infusion system: a superior method for the resuscitation of hypovolemic trauma patients
Dunham CM, Belzberg H, Lyles R, Weireter L, Skurdal D, Sullivan G, Esposito T, Namini M
Resuscitation. 1991;21((2-3):):207-27.
Abstract
The rapid infusion system (RIS), which can deliver fluids/blood products rapidly at precise rates and normothermic conditions, was compared with conventional fluid administration (CFA) in a randomized study of 36 hypovolemic trauma patients. Admission stratification criteria of the groups were similar relative to age, Glasgow Coma Score (GCS), Injury Severity Score (ISS) and plasma lactate. Despite the lack of difference in blood loss between the 24-h survivors of the two groups, the CFA group required greater total fluids (23.6/20.21), red blood cells (5.5/4.61), fresh frozen plasma (FFP) (2.8/1.91), platelets (523/204 ml), and crystalloids (12.9/10.61). Lactate levels were lower in the RIS group at virtually all times from hours 1 to 24 (4.3/5.3 mM/l, t-value = 3.3, DF = 279, P = 0.001). Post-admission hypothermia was greater in the CFA group at all times during the first 24 h (35.2/36.4 degrees C, t-value = 5.6, DF = 250, P = 0.001). The mean partial thromboplastin time was significantly higher in the CFA group (47.3/35.1 s, t-value = 3.1, DF = 279, P = 0.002). The PTT and PT were related to the degree of lactic acidosis (P = 0.0001) and hypothermia (P = 0.001) but not to the amount of FFP given (P = 0.14). The hospital costs, days in the ICU, and days on the ventilator were greater for the CFA group, as was the incidence of pneumonia (0/11 vs. 6/17; P = 0.03). Hypovolemic trauma patients resuscitated with the RIS needed fewer fluid/blood products and had less coagulopathy; more rapid resolution of hypoperfusion acidosis; better temperature preservation; and fewer hospital complications than those resuscitated with conventional methods of fluid/blood product administration.