Tags

Type your tag names separated by a space and hit enter

Impact of plasma transfusion in massively transfused trauma patients.
J Trauma. 2009 Mar; 66(3):693-7.JT

Abstract

OBJECTIVE

The objective of this study was to determine the optimal use of fresh-frozen plasma (FFP) in trauma. Our hypothesis was that a higher FFP: packed red blood cells (PRBC) ratio is associated with improved survival.

METHODS

This is a 6-year retrospective trauma registry and blood bank database study in a level I trauma center. All massively transfused patients (> or =10 PRBC during 24 hours) were analyzed. Patients with severe head trauma (head Abbreviated Injury Severity score > or =3) were excluded from the analysis. Patients were classified into four groups according to the FFP:PRBC ratio received: low ratio (< or =1:8), medium ratio (>1:8 and < or =1:3), high ratio (>1:3 and < or =1:2), and highest ratio (>1:2).

RESULTS

Of 25,599 trauma patients, 4,241 (16.6%) received blood transfusion. Massive transfusion occurred in 484 (11.4%) of the transfused. After exclusion of 101 patients with severe head injury 383 patients were available for analysis. The mortality rate decreased significantly with increased FFP transfusion. However, there does not seem to be a survival advantage after a 1:3 FFP:PRBC ratio has been reached. Using the highest ratio group as a reference, the relative risk of death was 0.97 (p = 0.97) for the high ratio group, 1.90 (p < 0.01) for the medium ratio group, and 3.46 (p < 0.01) for the low ratio group. There was an increasing trend toward more FFP use during time with the mean units per patient increasing 83% from 6.3 +/- 4.6 in 2000 to 11.5 +/- 9.7 in 2005.

CONCLUSION

Higher FFP:PRBC ratio is an independent predictor of survival in massively transfused patients. Aggressive early use of FFP may improve outcome in massively transfused trauma patients.

Authors+Show Affiliations

Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19276739

Citation

Teixeira, Pedro G R., et al. "Impact of Plasma Transfusion in Massively Transfused Trauma Patients." The Journal of Trauma, vol. 66, no. 3, 2009, pp. 693-7.
Teixeira PG, Inaba K, Shulman I, et al. Impact of plasma transfusion in massively transfused trauma patients. J Trauma. 2009;66(3):693-7.
Teixeira, P. G., Inaba, K., Shulman, I., Salim, A., Demetriades, D., Brown, C., Browder, T., Green, D., & Rhee, P. (2009). Impact of plasma transfusion in massively transfused trauma patients. The Journal of Trauma, 66(3), 693-7. https://doi.org/10.1097/TA.0b013e31817e5c77
Teixeira PG, et al. Impact of Plasma Transfusion in Massively Transfused Trauma Patients. J Trauma. 2009;66(3):693-7. PubMed PMID: 19276739.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of plasma transfusion in massively transfused trauma patients. AU - Teixeira,Pedro G R, AU - Inaba,Kenji, AU - Shulman,Ira, AU - Salim,Ali, AU - Demetriades,Demetrios, AU - Brown,Carlos, AU - Browder,Timothy, AU - Green,Donald, AU - Rhee,Peter, PY - 2009/3/12/entrez PY - 2009/3/12/pubmed PY - 2009/3/31/medline SP - 693 EP - 7 JF - The Journal of trauma JO - J Trauma VL - 66 IS - 3 N2 - OBJECTIVE: The objective of this study was to determine the optimal use of fresh-frozen plasma (FFP) in trauma. Our hypothesis was that a higher FFP: packed red blood cells (PRBC) ratio is associated with improved survival. METHODS: This is a 6-year retrospective trauma registry and blood bank database study in a level I trauma center. All massively transfused patients (> or =10 PRBC during 24 hours) were analyzed. Patients with severe head trauma (head Abbreviated Injury Severity score > or =3) were excluded from the analysis. Patients were classified into four groups according to the FFP:PRBC ratio received: low ratio (< or =1:8), medium ratio (>1:8 and < or =1:3), high ratio (>1:3 and < or =1:2), and highest ratio (>1:2). RESULTS: Of 25,599 trauma patients, 4,241 (16.6%) received blood transfusion. Massive transfusion occurred in 484 (11.4%) of the transfused. After exclusion of 101 patients with severe head injury 383 patients were available for analysis. The mortality rate decreased significantly with increased FFP transfusion. However, there does not seem to be a survival advantage after a 1:3 FFP:PRBC ratio has been reached. Using the highest ratio group as a reference, the relative risk of death was 0.97 (p = 0.97) for the high ratio group, 1.90 (p < 0.01) for the medium ratio group, and 3.46 (p < 0.01) for the low ratio group. There was an increasing trend toward more FFP use during time with the mean units per patient increasing 83% from 6.3 +/- 4.6 in 2000 to 11.5 +/- 9.7 in 2005. CONCLUSION: Higher FFP:PRBC ratio is an independent predictor of survival in massively transfused patients. Aggressive early use of FFP may improve outcome in massively transfused trauma patients. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/19276739/Impact_of_plasma_transfusion_in_massively_transfused_trauma_patients_ L2 - https://doi.org/10.1097/TA.0b013e31817e5c77 DB - PRIME DP - Unbound Medicine ER -