Effects of modification of trauma bleeding management: A before and after study

Anaesthesia Critical Care & Pain Medicine
Cécile GuthJean-Stéphane David

Abstract

We hypothesised that the association of tranexamic acid (TXA) administration and thromboelastometry-guided haemostatic therapy (TGHT) with implementation of Damage Control Resuscitation (DCR) reduced blood products (BP) use and massive transfusion (MT). Retrospective comparison of 2 cohorts of trauma patients admitted in a university hospital, before (Period 1) and after implementation of DCR, TXA (first 3-hours) and TGHT (Period 2). Patients were included if they received at least 1 BP (RBC, FFP or platelet) or coagulation factor concentrates (fibrinogen or prothrombin complex) during the first 24-hours following the admission. 380 patients were included. Patients in Period 2 (n = 182) received less frequently a MT (8% vs. 33%, P < 0.01), significantly less BP (RBC: 2 units [1-5] vs. 6 [3-11]; FFP: 0 units [0-2] vs. 4 [2-8]) but more fibrinogen concentrates (3.0 g [1.5-4.5] vs. 0.0 g [0.0-3.0], P < 0.01). Multivariate logistic regression analysis identified Period 1 as being associated with an increased risk of receiving MT (OR: 26.1, 95% CI: 9.7-70.2) and decreased survival at 28 days (OR: 2.0, 95% CI: 1.0-3.9). After propensity matching, the same results were observed but there was no difference for survival and a significan...Continue Reading

References

Nov 18, 2006·Journal of Thrombosis and Haemostasis : JTH·L RugeriC Negrier
Mar 8, 2011·Critical Care : the Official Journal of the Critical Care Forum·Herbert SchöchlCristina Solomon
Mar 21, 2013·The Journal of Trauma and Acute Care Surgery·Stephen R OdomDaniel Talmor
Jun 13, 2013·Anesthesia and Analgesia·Herbert Schöchl, Christoph J Schlimp
Oct 24, 2014·Current Opinion in Critical Care·Andrew Cap, Beverley Hunt
Apr 17, 2015·Critical Care : the Official Journal of the Critical Care Forum·Giuseppe NardiGiulia Ranaldi
Jan 29, 2016·British Journal of Haematology·Gregory A Hans, Martin W Besser
Apr 14, 2016·Critical Care : the Official Journal of the Critical Care Forum·Rolf RossaintDonat R Spahn
Sep 13, 2016·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·J S DavidK Tazarourte
Feb 28, 2017·Current Opinion in Anaesthesiology·Alexander A HankeMichaela Wilhelmi
Mar 21, 2017·Anesthesia and Analgesia·Jerrold H LevySibylle Kozek-Langenecker
Jul 30, 2017·The Lancet. Haematology·Jean-Stéphane David, Pierre Bouzat

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Citations

Aug 28, 2019·Anaesthesia Critical Care & Pain Medicine·Tobias GaussPierre Bouzat
Oct 22, 2019·Anaesthesia Critical Care & Pain Medicine·Jean-Stéphane David, Kenji Inaba
Dec 26, 2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Jean-Stephane DavidKenji Inaba

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