tailieunhanh - Báo cáo y học: " Freeze dried plasma: a French army specialty"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Freeze dried plasma: a French army specialty. | Daban et al. Critical Care 2010 14 412 http content 14 2 412 CRITICAL CARE LETTER L_ Freeze dried plasma a French army specialty Jean Louis Daban1 Patrick Clapson1 Sylvain Ausset 1 Anne V Deshayes2 and Anne Sailliol2 See related review by Nascimento etal. http 14 1 202 We read with interest the article by Nascimento and colleagues 1 on fresh frozen plasma FFP in massive bleedings. We fully agree with their conclusion when they say that we need immediately available universal donor AB plasma. Hemorrhagic shock is the primary cause of avoidable mortality in combatants. Data from the recent US army war experience show clearly that in cases of massive transfusion the transfusion policy strongly impacts mortality. Namely for massive bleeding the ratio between red blood cells and clotting factors should be close to the composition of whole blood 2 . Plasma is thus essential for massive transfusions. But FFP use is impractical in uncertain environments such as a battlefield. During military operations refrigerated transportation and storage are logistical problems. Thawing of FFP takes a long time with an important loss of plasma in austere environments. For example Mabry and colleagues 3 report that during the Mogadishu urban battle the available FFP was stored in bags that fractured one-third of the time upon thawing. For these reasons the French army has used freeze-dried and secured plasma FDSP since 1994. Plasma separated from fresh blood of at least ten donors is lyophilized to produce FSDP. Blood type selection allows the dilution and neutralization of natural anti-A and antiB hemagglutinins. This FDSP is thus compatible with any blood type. In addition FDSP is shelf-stable in ambient temperatures for 2 years and easily rehydrated with 200 ml of water for injections in less than 3 minutes allowing immediate provision with the first packed red blood cells 4 . FDSP contains all clotting factors and proteins. After more than 2 years .