tailieunhanh - Báo cáo y học: " Blood product ratio in acute traumatic coagulopathy - effect on mortality in a Scandinavian level 1 trauma centre"

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: Blood product ratio in acute traumatic coagulopathy - effect on mortality in a Scandinavian level 1 trauma centre | Dirks et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 65 http content 18 1 65 SCANDINAVIAN JOURNAL OF t emergency medicine ORIGINAL RESEARCH Open Access Blood product ratio in acute traumatic coagulopathy - effect on mortality in a Scandinavian level 1 trauma centre 1 1 3 2 2 Jesper Dirks Henrik J0rgensen Carsten H Jensen Sisse R Ostrowski Par I Johansson Abstract Background Trauma is the leading cause of loss of life expectancy worldwide. In the most seriously injured patients coagulopathy is often present on admission. Therefore transfusion strategies to increase the ratio of plasma FFP and platelets PLT to red blood cells RBC simulating whole blood have been introduced. Several studies report that higher ratios improve survival in massively bleeding patients. Here the aim was to investigate the potential effect of increased FFP and PLT to RBC on mortality in trauma patients. Methods In a retrospective before and after study all trauma patients primarily admitted to a level-one Trauma Centre receiving blood transfusion in 2001-3 n 97 and 2005-7 n 156 were included. In 2001-3 FFP and PLT were administered in accordance with the American Society of Anesthesiologists ASA guidelines whereas in 2005-7 Hemostatic Control Resuscitation HCR entailing pre-emptive use of FFP and PLT in transfusion packages during uncontrolled haemorrhage and thereafter guided by thrombelastograph TEG analysis was employed. The effect of transfusion therapy and coagulopathy on mortality was investigated. Results Patients included in the early and late period had comparable demography injury severity score ISS admission hematology and coagulopathy 27 vs. 34 had APTT above normal . There was a significant change in blood transfusion practice with shorter time interval from admission to first transfusion median time 3 min min in massive bleeders p transfusion of higher ratios of FFP RBC PLT RBC and PLT FFP in the HCR group but .