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Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
Massive blood transfusion and trauma resuscitation
Biswadev Mitra1, Alfredo Mori, Peter A Cameron
1Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia. b.mitra@alfred.org.au
Injury
|June 19, 2007
Summary
Massive transfusion of packed red blood cells (PRBCs) in trauma patients did not predict mortality. Early hypotension, pelvic fractures, and coagulopathy predicted the need for massive transfusion and mortality.
Area of Science:
- Trauma care
- Resuscitation medicine
- Transfusion medicine
Background:
- Massive transfusion protocols are critical in managing severe trauma.
- Understanding predictors of massive transfusion and mortality is essential for optimizing patient outcomes.
Purpose of the Study:
- To review massive transfusion practices during initial trauma resuscitation.
- To identify factors predicting massive transfusion and mortality in trauma patients.
Main Methods:
- Retrospective analysis of 119 trauma patients receiving ≥5 units of PRBCs within 4 hours.
- Analysis of demographics, injuries, clinical features, and transfusion volumes.
- Identification of predictors for massive transfusion and mortality.
Main Results:
- 27.7% mortality in patients requiring massive transfusion.
- Predictors of massive transfusion included hypotension, pelvic fractures, kidney injuries, acidaemia, and thrombocytopaenia.
- Injury Severity Score, coagulopathy (APTT), and head injuries predicted mortality.
Conclusions:
- Volume of blood transfused was not an independent predictor of mortality.
- Further prospective studies are needed to develop evidence-based massive transfusion guidelines.
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