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Blood Transfusion and Agglutination02:45

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
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Basic Research in Plasma Medicine - A Throughput Approach from Liquids to Cells
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Liquid plasma use during "super" massive transfusion protocol.

Casey J Allen1, Sherry Shariatmadar1, Jonathan P Meizoso1

  • 1Departments of Surgery, Pathology, and Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida.

The Journal of Surgical Research
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PubMed
Summary
This summary is machine-generated.

Implementing liquid plasma (LP) in massive transfusion protocols (MTP) improved the packed red blood cell (PRBC) to plasma ratio in patients with severe trauma (S-MTP). This change reduced the PRBC:plasma ratio, optimizing blood product allocation during critical care.

Keywords:
Acute coagulopathy of traumaFFPHemostatic resuscitationMTP

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Area of Science:

  • Trauma resuscitation and critical care medicine
  • Blood banking and transfusion services
  • Hemorrhagic shock management

Background:

  • Massive transfusion protocols (MTP) pose logistical challenges for blood banks and trauma centers.
  • Comparing transfusion ratios in standard MTP (10-30 U PRBC/24 h) versus "super" MTP (S-MTP; >30 U PRBC/24 h) is crucial.
  • Investigating the impact of liquid plasma (LP) on PRBC:plasma ratios during S-MTP is essential for optimizing patient care.

Purpose of the Study:

  • To compare the packed red blood cell (PRBC) to plasma transfusion ratios in patients undergoing MTP versus S-MTP.
  • To test the hypothesis that incorporating readily available liquid plasma (LP) improves PRBC:plasma ratios in S-MTP.
  • To evaluate the effect of institutional changes in blood product allocation on transfusion dynamics.

Main Methods:

  • Retrospective review of 1305 transfused trauma patients from January 2009 to April 2015.
  • Comparison of PRBC:plasma ratios for MTP (n=277) and S-MTP (n=61) patients before and after LP availability.
  • Statistical analysis using mean ± standard deviation or median (interquartile range) to report data.

Main Results:

  • S-MTP patients initially presented with a higher PRBC:plasma ratio (2.1:1) compared to MTP patients (1.7:1) within the first hour (P=0.017).
  • Introduction of LP significantly reduced the PRBC:plasma ratio in S-MTP patients during the first hour (P < 0.001).
  • Before LP, PRBC:plasma positively correlated with PRBC transfused at hour 1 (r=0.410); this correlation disappeared after LP implementation (r=0.177).

Conclusions:

  • Early transfusion ratios in S-MTP patients were characterized by a higher PRBC:plasma ratio, which correlated with PRBC units transfused.
  • Institutional protocol changes incorporating LP significantly improved the early PRBC:plasma ratio for S-MTP patients.
  • The availability of liquid plasma optimizes blood product utilization in the management of severe trauma patients requiring massive transfusions.