High transfusion ratios are not associated with increased complication rates in patients with severe extremity injuries

The Journal of Trauma
Philbert Y VanLorne H Blackbourne

Abstract

High transfusion ratios of plasma to packed red blood cells (>1:2) have been associated with increased survival and increased complications in patients receiving massive transfusion (MT). We hypothesized that high ratio transfusion would be associated with no survival benefit and increased complications in combat victims with compressible hemorrhage. A retrospective analysis of soldiers injured in the current conflict during 5 years (n = 2,105) who received blood was performed on those with isolated extremity (abbreviated injury scale extremity score > or = 3 and abbreviated injury scale score 0-2 in all other regions) injury comparing those who received a MT with those who did not. Transfusion ratios in the first 24 hours were correlated with outcomes. Injury severity score (14.6 vs. 12.1; p < 0.05), international normalized ratio (1.65 vs. 1.28; p < 0.05), and base deficit (8.0 vs. 3.7; p < 0.05) were higher in the MT group. High transfusion ratios were associated with a trend toward decreased mortality (17.2% vs. 6.9%; p = 0.07) in MT patients and no increased complications (20.7% vs. 26.4%; p > 0.05). In those receiving a non-MT, high ratios were associated with similar mortality (4.8% vs. 3.9%; p > 0.05) and complications ...Continue Reading

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Jun 19, 2003·The Journal of Trauma·Karim BrohiTimothy Coats
Jul 12, 2003·The Journal of Trauma·Jana B A MacLeodMary Murtha
Aug 17, 2005·Vox Sanguinis·P I JohanssonH Sørensen
Jun 10, 2006·The Journal of Trauma·Lloyd KetchumSeppo Hiippala
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Citations

Jul 13, 2012·Journal of Emergencies, Trauma, and Shock·Pär I JohanssonSisse R Ostrowski
Nov 17, 2012·The Surgical Clinics of North America·Leslie KobayashiRaul Coimbra
Apr 5, 2015·International Journal of Obstetric Anesthesia·Rhidian Jones, Rachel E Collis
Jan 30, 2014·Perioperative Medicine·Timothy E Miller
Jan 25, 2013·Journal of Orthopaedic Trauma·Krisztian SisakZsolt J Balogh
Apr 12, 2012·The Journal of Trauma and Acute Care Surgery·Charles E Lucas, Anna M Ledgerwood
Mar 10, 2011·Current Opinion in Anaesthesiology

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