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Ned Tijdschr Geneeskd · Jan 2011
Review[Transfusion policy in trauma involving massive blood loss].
- Teun Peter Saltzherr, Sarah C Christiaans, C Pieter Henny, Marcel M Levi, and J Carel Goslings.
- Academisch Medisch Centrum, Afd. Chirurgie, Trauma Unit, Amsterdam, The Netherlands. t.p.saltzherr@amc.uva.nl
- Ned Tijdschr Geneeskd. 2011 Jan 1;155:A2306.
AbstractSevere haemorrhage is a significant cause of death in trauma patients. In the case of massive blood loss a combination of coagulation defects, acidosis and hypothermia arise, which are accompanied by high morbidity and mortality rates unless properly corrected. Research in wounded military showed that a high ratio of fresh frozen plasma to packed red blood cells (FFP:PRBC) seemed to have a positive effect on survival. These studies do not provide a definition of the ideal ratio FFP:PRBC; the ratio in which a positive effect is seen varies from 1:1 to 1:3. Unnecessary FFP transfusions in trauma patients without imminent severe haemorrhage increase the risk of complications such as multi-organ failure and acute respiratory distress syndrome. Additional research is required into the accuracy of diagnosis of acute coagulation disorders.
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