Global Journal of Transfusion Medicine | |
Blood component therapy in trauma | |
article | |
Ambuja Kantharaj1  Shivaram Chandrashekar1  | |
[1] Department of Transfusion Medicine, Manipal Hospitals | |
关键词: Acute traumatic coagulopathy; blood component; massive transfusion; trauma; | |
DOI : 10.4103/2455-8893.189855 | |
学科分类:社会科学、人文和艺术(综合) | |
来源: Wolters Kluwer Medknow Publications | |
【 摘 要 】
Background: Injury is the leading cause of life years lost, and hemorrhage is responsible for 40% of all trauma deaths and is commonly associated with coagulopathy, necessitating the use of blood and blood components. With logistical issues and concerns regarding safety of fresh whole blood because of the abbreviated less-sensitive technologies involved in testing, component therapy has emerged as an effective alternative to fresh whole blood in civilian settings. This study aims to study the outcomes of trauma patients requiring blood transfusion in an emergency setting of a tertiary care hospital. Materials and Methods: This is a 1-year retrospective study conducted at a tertiary care multispecialty hospital from July 2013 to June 2014. During the period, 1352 patients presented to the emergency department; their blood usage and mortality were studied. Results: Of the 1352 patients who presented with trauma due to road traffic accidents, history of fall, and assault, only 107 (7.9%) needed hospitalization due to grievous injuries. Of the hospitalized patients, only 16 (15%) needed blood component transfusions and 6 of them died giving a mortality rate of 5.6%. Five of the six deceased patients had a high prothrombin time ratio over 1.5, but only two of them received fresh frozen plasma transfusions. The mortality rate of 5.6% (6/107) was lower compared to other similar studies. Conclusion: Medical management probably plays a more important role than transfusion of blood in acute trauma cases. Although conventional protocols where transfusion is carried out after laboratory tests for coagulopathy have yielded good survival rates, use of newer point-of-care testing such as thromboelastogram and improved communication between the blood users and blood banks coupled with a good massive transfusion protocol (MTP) will help in better management of bleeding associated with trauma. Adequate randomized controlled studies to demonstrate the superiority of 1:1:1 MTP as opposed to conventional protocols are lacking.
【 授权许可】
CC BY-NC-SA
【 预 览 】
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RO202106150002442ZK.pdf | 785KB | download |