J Korean Med Sci.  2014 Jul;29(7):1007-1011. 10.3346/jkms.2014.29.7.1007.

Application of Damage Control Resuscitation Strategies to Patients with Severe Traumatic Hemorrhage: Review of Plasma to Packed Red Blood Cell Ratios at a Single Institution

• Kim Y
• Lee K
• Kim J
• Kim J
• Heo Y
• Wang H
• Lee K
• Jung K

• KMID: 1789963
• DOI: http://doi.org/10.3346/jkms.2014.29.7.1007

Abstract

When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (> or =0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.

Keyword

Resuscitation; Transfusion; Blood Product Ratio; Survival; Trauma

MeSH Terms

Acute Lung Injury/epidemiology/etiology
Adolescent
Adult
Aged
Aged, 80 and over
Bacterial Infections/epidemiology
*Blood Transfusion/adverse effects
*Erythrocyte Transfusion/adverse effects
Female
Hemorrhage/etiology/*prevention & control
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Patients
Respiratory Distress Syndrome, Adult/epidemiology/etiology
Resuscitation
Retrospective Studies
Wounds and Injuries/complications/mortality/*therapy
Young Adult

Figure

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  Fig. 1 Kaplan-Meier survival plots for the 2 groups. (A) First 24 hr, (B) First 30 days after admission.

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