The impact of prehospital whole blood on hemorrhaging trauma patients: A multi-center retrospective study

医学 创伤中心 血液制品 堆积红细胞 损伤严重程度评分 急诊医学 输血 复苏 新鲜冰冻血浆 人口统计学的 单变量分析 休克(循环) 血流动力学 麻醉 回顾性队列研究 急诊科 内科学 外科 血小板 毒物控制 伤害预防 多元分析 人口学 社会学 精神科
作者
M.A. Braverman,Steven G Schauer,Angelo Ciaraglia,Erika Brigmon,Alison Smith,Lauran Barry,James A. Bynum,Donna T. Andrew,Hannah Corral,Andrew D Fisher,Eric Epley,Rachelle B. Jonas,Michael Shiels,Elizabeth Waltman,C Winckler,Brian J. Eastridge,Ronald M. Stewart,Susannah E. Nicholson,Donald H. Jenkins
出处
期刊:The journal of trauma and acute care surgery [Lippincott Williams & Wilkins]
卷期号:95 (2): 191-196 被引量:5
标识
DOI:10.1097/ta.0000000000003908
摘要

BACKGROUND Whole blood (WB) use has become increasingly common in trauma centers across the United States for both in-hospital and prehospital resuscitation. We hypothesize that prehospital WB (pWB) use in trauma patients with suspected hemorrhage will result in improved hemodynamic status and reduced in-hospital blood product requirements. METHODS The institutional trauma registries of two academic level I trauma centers were queried for all patients from 2015–2019 who underwent transfusion upon arrival to the trauma bay. Patients who were dead on arrival or had isolated head injuries were excluded. Demographics, injury and shock characteristics, transfusion requirements, including massive transfusion protocol (MTP) (>10 U in 24 hours) and rapid transfusion (CAT3+) and outcomes were compared between pWB and non-pWB patients. Significantly different demographic, injury characteristics and pWB were included in univariate followed by stepwise logistic regression analysis to determine the relationship with shock index (SI). Our primary objective was to determine the relationship between pWB and improved hemodynamics or reduction in blood product utilization. RESULTS A total of 171 pWB and 1391 non-pWB patients met inclusion criteria. Prehospital WB patients had a lower median Injury Severity Score (17 vs. 21, p < 0.001) but higher prehospital SI showing greater physiologic disarray. Prehospital WB was associated with improvement in SI (−0.04 vs. 0.05, p = 0.002). Mortality and (LOS) were similar. Prehospital WB patients received fewer packed red blood cells, fresh frozen plasma, and platelets units across their LOS but total units and volumes were similar. Prehospital WB patients had fewer MTPs (22.6% vs. 32.4%, p = 0.01) despite a similar requirement of CAT3+ transfusion upon arrival. CONCLUSION Prehospital WB administration is associated with a greater improvement in SI and a reduction in MTP. This study is limited by its lack of power to detect a mortality difference. Prospective randomized controlled trials will be required to determine the true impact of pWB on trauma patients. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
喜悦的向日葵完成签到,获得积分10
2秒前
纸柒完成签到 ,获得积分10
3秒前
4秒前
肖战战完成签到 ,获得积分10
5秒前
一一一应助songvv采纳,获得10
7秒前
量子星尘发布了新的文献求助10
7秒前
陶一二完成签到,获得积分10
8秒前
MM完成签到,获得积分10
9秒前
Who1990完成签到,获得积分10
10秒前
李友健完成签到 ,获得积分10
11秒前
hhhhh完成签到 ,获得积分10
13秒前
可耐的乘风完成签到,获得积分10
15秒前
wangnn发布了新的文献求助20
15秒前
大橙子发布了新的文献求助10
16秒前
16秒前
16秒前
余慵慵完成签到 ,获得积分10
17秒前
奋斗的小土豆完成签到,获得积分10
18秒前
ZJJ静完成签到,获得积分10
18秒前
邢大宝完成签到,获得积分10
19秒前
尔玉完成签到 ,获得积分10
21秒前
memo完成签到,获得积分10
21秒前
21秒前
一路芬芳完成签到,获得积分20
21秒前
23秒前
一一一应助songvv采纳,获得10
23秒前
23秒前
SciKid524完成签到 ,获得积分10
25秒前
科研通AI2S应助hhh采纳,获得10
25秒前
QWE完成签到,获得积分10
25秒前
赛赛完成签到 ,获得积分10
27秒前
tinydog完成签到,获得积分10
29秒前
长情琦完成签到,获得积分10
29秒前
Mercury完成签到 ,获得积分10
31秒前
zx完成签到 ,获得积分10
32秒前
Dearjw1655完成签到,获得积分10
33秒前
123完成签到 ,获得积分10
33秒前
圆圆完成签到 ,获得积分10
34秒前
38秒前
哭泣笑柳发布了新的文献求助10
39秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038201
求助须知:如何正确求助?哪些是违规求助? 3575940
关于积分的说明 11373987
捐赠科研通 3305747
什么是DOI,文献DOI怎么找? 1819274
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022