Tags

Type your tag names separated by a space and hit enter

Crystalloid resuscitation improves survival in trauma patients receiving low ratios of fresh frozen plasma to packed red blood cells.
J Trauma. 2011 Aug; 71(2 Suppl 3):S380-3.JT

Abstract

BACKGROUND

Current trauma resuscitation guidelines recommend giving an initial crystalloid bolus as first line for resuscitation. Recent studies have shown a survival benefit for trauma patients resuscitated with high ratios of fresh frozen plasma (FFP) to packed red blood cells (PRBC). Our aim was to determine whether the volume of crystalloid given during resuscitation correlated with differences in morbidity or mortality based on the ratio of FFP:PRBC given.

METHODS

This was a retrospective review of 2,473 transfused trauma patients at 23 Level I trauma centers from July 2005 to October 2007. Patients were separated based on the ratios of FFP:PRBC they received (<1:4, 1:4-1:1, and >1:1) and then analyzed for morbidity and mortality based on whether or not they received at least 1 L crystalloid for each unit of PRBC. Outcomes analyzed were 6-hour, 24-hour, and 30-day survival as well as intensive care unit (ICU)-free days, ventilator-free days, and hospital-free days.

RESULTS

Massive transfusion patients who received <1:4 ratios of FFP:PRBC had significantly improved 6-hour, 24-hour, and 30-day mortality and significantly more ventilator-free days if they received at least 1 L of crystalloid for each unit of PRBC. Nonmassive transfusion patients who received <1:4 ratios of FFP:PRBC had significantly improved 6-hour, 24-hour, and 30-day mortality and significantly more ICU-free days, ventilator-free days, and hospital-free days if they received at least 1 L crystalloid for each unit of PRBC. In both massive and nonmassive transfusion groups, the survival benefit and morbidity benefit was progressively less for the 1:4 to 1:1 FFP:PRBC groups and >1:1 FFP:PRBC groups.

CONCLUSIONS

If high ratios of FFP:PRBC are unable to be given to trauma patients, resuscitation with at least 1 L of crystalloid per unit of PRBC is associated with improved overall mortality.

Authors+Show Affiliations

Division of Trauma and Critical Care, Oregon Health & Science University, Portland, Oregon 97239, USA. spoerken@ohsu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

21814108

Citation

Spoerke, Nicholas, et al. "Crystalloid Resuscitation Improves Survival in Trauma Patients Receiving Low Ratios of Fresh Frozen Plasma to Packed Red Blood Cells." The Journal of Trauma, vol. 71, no. 2 Suppl 3, 2011, pp. S380-3.
Spoerke N, Michalek J, Schreiber M, et al. Crystalloid resuscitation improves survival in trauma patients receiving low ratios of fresh frozen plasma to packed red blood cells. J Trauma. 2011;71(2 Suppl 3):S380-3.
Spoerke, N., Michalek, J., Schreiber, M., Brasel, K. J., Vercruysse, G., MacLeod, J., Dutton, R. P., Duchesne, J. C., McSwain, N. E., Muskat, P., Johannigamn, J., Cryer, H. M., Tillou, A., Cohen, M. J., Pittet, J. F., Knudson, P., De Moya, M. A., Tieu, B., Brundage, S., ... Marin, B. (2011). Crystalloid resuscitation improves survival in trauma patients receiving low ratios of fresh frozen plasma to packed red blood cells. The Journal of Trauma, 71(2 Suppl 3), S380-3. https://doi.org/10.1097/TA.0b013e318227f1c5
Spoerke N, et al. Crystalloid Resuscitation Improves Survival in Trauma Patients Receiving Low Ratios of Fresh Frozen Plasma to Packed Red Blood Cells. J Trauma. 2011;71(2 Suppl 3):S380-3. PubMed PMID: 21814108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Crystalloid resuscitation improves survival in trauma patients receiving low ratios of fresh frozen plasma to packed red blood cells. AU - Spoerke,Nicholas, AU - Michalek,Joel, AU - Schreiber,Martin, AU - ,, AU - Brasel,K J, AU - Vercruysse,G, AU - MacLeod,J, AU - Dutton,R P, AU - Duchesne,J C, AU - McSwain,N E, AU - Muskat,P, AU - Johannigamn,J, AU - Cryer,H M, AU - Tillou,A, AU - Cohen,M J, AU - Pittet,J F, AU - Knudson,P, AU - De Moya,M A, AU - Tieu,B, AU - Brundage,S, AU - Napolitano,L M, AU - Brunsvold,M, AU - Sihler,K C, AU - Peitzman,A B, AU - Zenait,M S, AU - Sperry,J, AU - Alarcon,L, AU - Croce,M A, AU - Minei,J P, AU - Stewart,R M, AU - Cohn,S M, AU - Mickalek,J E, AU - Bulger,E M, AU - Cotton,B A, AU - Nunez,T C, AU - Ivatury,R, AU - Meredith,J W, AU - Miller,P, AU - Pomper,G J, AU - Marin,B, PY - 2011/8/5/entrez PY - 2011/9/20/pubmed PY - 2011/10/25/medline SP - S380 EP - 3 JF - The Journal of trauma JO - J Trauma VL - 71 IS - 2 Suppl 3 N2 - BACKGROUND: Current trauma resuscitation guidelines recommend giving an initial crystalloid bolus as first line for resuscitation. Recent studies have shown a survival benefit for trauma patients resuscitated with high ratios of fresh frozen plasma (FFP) to packed red blood cells (PRBC). Our aim was to determine whether the volume of crystalloid given during resuscitation correlated with differences in morbidity or mortality based on the ratio of FFP:PRBC given. METHODS: This was a retrospective review of 2,473 transfused trauma patients at 23 Level I trauma centers from July 2005 to October 2007. Patients were separated based on the ratios of FFP:PRBC they received (<1:4, 1:4-1:1, and >1:1) and then analyzed for morbidity and mortality based on whether or not they received at least 1 L crystalloid for each unit of PRBC. Outcomes analyzed were 6-hour, 24-hour, and 30-day survival as well as intensive care unit (ICU)-free days, ventilator-free days, and hospital-free days. RESULTS: Massive transfusion patients who received <1:4 ratios of FFP:PRBC had significantly improved 6-hour, 24-hour, and 30-day mortality and significantly more ventilator-free days if they received at least 1 L of crystalloid for each unit of PRBC. Nonmassive transfusion patients who received <1:4 ratios of FFP:PRBC had significantly improved 6-hour, 24-hour, and 30-day mortality and significantly more ICU-free days, ventilator-free days, and hospital-free days if they received at least 1 L crystalloid for each unit of PRBC. In both massive and nonmassive transfusion groups, the survival benefit and morbidity benefit was progressively less for the 1:4 to 1:1 FFP:PRBC groups and >1:1 FFP:PRBC groups. CONCLUSIONS: If high ratios of FFP:PRBC are unable to be given to trauma patients, resuscitation with at least 1 L of crystalloid per unit of PRBC is associated with improved overall mortality. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/21814108/Crystalloid_resuscitation_improves_survival_in_trauma_patients_receiving_low_ratios_of_fresh_frozen_plasma_to_packed_red_blood_cells_ L2 - https://doi.org/10.1097/TA.0b013e318227f1c5 DB - PRIME DP - Unbound Medicine ER -