Traditional transfusion practices are changing
- PMID: 20550726
- PMCID: PMC2911712
- DOI: 10.1186/cc9009
Traditional transfusion practices are changing
Abstract
Schochl and co-authors have described a 5-year retrospective study that outlines a novel, important and controversial transfusion concept in seriously injured trauma patients. Traditionally, clinicians have been taught to use a serial approach, resuscitating hypovolemic trauma patients with a form of crystalloid or colloid, followed by red blood cells (RBCs), then fresh frozen plasma (FFP), and lastly platelets. The data supporting this widely accepted approach are remarkably weak. Conversely, Schochl and colleagues, in an innovative, retrospective study, describe the use of fibrinogen concentrate, plasma complex concentrate, RBCs, FFP, and platelets driven by a thromboelastometry-based algorithm. Finally, it appears that transfusion therapy is becoming driven by physiology.
Comment on
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Goal-directed coagulation management of major trauma patients using thromboelastometry (ROTEM)-guided administration of fibrinogen concentrate and prothrombin complex concentrate.Crit Care. 2010;14(2):R55. doi: 10.1186/cc8948. Epub 2010 Apr 7. Crit Care. 2010. PMID: 20374650 Free PMC article.
References
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- Schoechl H, Nienaber U, Jambor C, Hofer G, Scharbert G, Voelckel W, Kozek-Langenecker S, Solomon C. Goal-directed coagulation management of major trauma patients using rotation thromboelastometry (ROTEM®)-guided administration of fibrinogen and prothrombin complex concentrate. Crit Care. 2010;14:R55. doi: 10.1186/cc8948. - DOI - PMC - PubMed
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- Holcomb JB, Wade CE, Michalek JE, Chisholm GB, Zarzabal LA, Schreiber MA, Gonzalez EA, Pomper GJ, Perkins JG, Spinella PC, Williams KL, Park MS. Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008;248:447–458. - PubMed
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- Pati S, Matijevic M, Doursout M, Ko T, Cao Y, Deng X, Kozar R, Hartwell E, Conyers J, Holcomb JB. The protective effects of fresh frozen plasma (FFP) on vascular endothelial permeability, coagulation, and resuscitation after hemorrhagic shock are time dependent and diminish between day 0 and day 5 after thaw. J Trauma. 2010. in press . - PMC - PubMed
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