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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

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Published on: March 14, 2017

Transfusion practice in military trauma.

J R Hess¹, J B Holcomb

¹Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA. jhess@umm.edu

Transfusion Medicine (Oxford, England)

|July 5, 2008

Summary

Trauma resuscitation with plasma and red blood cells (RBCs) in a 1:1 ratio improves hemostasis and survival in critically injured patients. Fresh whole blood is a life-saving option in field emergencies.

Area of Science:

Trauma Surgery
Emergency Medicine
Hemorrhagic Shock Resuscitation

Background:

Modern warfare leads to severe injuries, with casualties often presenting with coagulopathy and shock.
Conventional crystalloid fluid resuscitation can worsen coagulopathy and increase blood loss.
Existing coagulopathy is challenging to manage in uncontrolled hemorrhage scenarios.

Purpose of the Study:

To evaluate the effectiveness of a 1:1 resuscitation strategy using thawed AB plasma and red blood cells (RBCs) for trauma casualties.
To assess the role of fresh whole blood as a platelet source in trauma resuscitation.
To determine if this approach improves hemostasis, reduces ventilator time, and enhances survival rates.

Main Methods:

Retrospective analysis of trauma resuscitation protocols.

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Implementation of a 1:1 ratio of thawed AB plasma to RBCs for initial resuscitation.

Utilization of fresh whole blood as a source of platelets when component therapy was unavailable.

Main Results:

The 1:1 plasma-to-RBC resuscitation strategy showed positive trends towards improved hemostasis.
Patients treated with this protocol experienced shorter durations of mechanical ventilation.
Retrospective data suggested an improvement in overall survival rates for casualties receiving this therapy.

Conclusions:

Early administration of plasma with RBCs in a 1:1 ratio is a promising resuscitation strategy for trauma patients with coagulopathy and shock.
Fresh whole blood can be a critical, life-saving intervention in austere or field environments.
Component therapy, when available, demonstrates comparable effectiveness to fresh whole blood in trauma resuscitation.