Prehospital Transfusion for Gastrointestinal Bleeding.

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Critical Care

Background:

• Gastrointestinal (GI) bleeding is a frequent medical emergency associated with high morbidity and mortality.
• Coagulopathy often complicates GI bleeding, potentially exacerbating blood loss.
• Early resuscitation strategies, including correction of coagulopathy and anemia, may improve outcomes for exsanguinating patients.

Purpose of the Study:

• To evaluate the impact of prehospital damage control resuscitation on patients with acute GI bleeding.
• To assess the effectiveness of early transfusion of packed red blood cells (pRBC) and/or plasma during transport.

Main Methods:

• Retrospective review of patients with acute GI bleeding who received pRBC and/or plasma during transport (2010-2014).
• Comparison with a control group of patients not transfused en route.
• Analysis of demographics, resuscitation response, and clinical outcomes.

Main Results:

• 112 patients received prehospital transfusions (pRBC, plasma, or both).
• Transfused patients showed significant improvements in hemoglobin and decreases in INR compared to the non-transfused group.
• Both groups experienced improved hemodynamic parameters with resuscitation.

Conclusions:

• Prehospital damage control resuscitation with pRBC and/or plasma effectively improved hemodynamic instability, coagulopathy, and anemia in acute GI bleeding patients.
• The need for subsequent inpatient interventions suggests appropriate patient selection for prehospital transfusion.