[Hemoglobin-oriented and coagulation factor-based algorithm : Effect on transfusion needs and standardized mortality...

Area of Science:

• Trauma resuscitation
• Hemorrhage management
• Coagulation disorders

Context:

• Trauma-induced coagulopathy (TIC) significantly contributes to early mortality in trauma patients.
• Aggressive correction of TIC is crucial for preventing death in patients with hemorrhage.
• A hemoglobin (Hb)-oriented and coagulation factor-based standard operating procedure (SOP) was implemented in a level 1 trauma center.

Purpose:

• To evaluate the effectiveness of the SOP in trauma patients requiring massive transfusions.
• To assess the impact of the SOP on transfusion requirements and standardized mortality ratio (SMR).
• To compare outcomes between patients treated before and after SOP implementation.

Summary:

• A retrospective study compared massively transfused trauma patients before (group 1) and after (group 2) SOP implementation.
• Group 2, treated with the SOP, showed a significant reduction in red blood cell transfusions (22.8 vs 17.6 units).
• The SOP also led to significantly improved hemostatic results (fibrinogen, Quick's value) on ICU admission.

Impact:

• The SOP demonstrated a clinically relevant trend towards reducing the SMR in massively transfused trauma patients.
• Significant reduction in transfusion requirements indicates more efficient resource utilization.
• Improved hemostatic results suggest better management of coagulopathy in severely injured patients, potentially improving survival rates.