Transfusion practices in trauma
Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Go...
Main Authors: | , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wolters Kluwer Medknow Publications
2014-01-01
|
Series: | Indian Journal of Anaesthesia |
Subjects: | |
Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2014;volume=58;issue=5;spage=609;epage=615;aulast=Ramakrishnan |
id |
doaj-0f029f1b8d39429a8c86b1e15725a85b |
---|---|
record_format |
Article |
spelling |
doaj-0f029f1b8d39429a8c86b1e15725a85b2020-11-24T22:24:31ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492014-01-0158560961510.4103/0019-5049.144668Transfusion practices in traumaV Trichur RamakrishnanSrihari CattamanchiResuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2014;volume=58;issue=5;spage=609;epage=615;aulast=RamakrishnanBlood transfusiondamage control resuscitationmassive transfusion protocolpacked red blood cellsplasmaplateletstrauma resuscitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
V Trichur Ramakrishnan Srihari Cattamanchi |
spellingShingle |
V Trichur Ramakrishnan Srihari Cattamanchi Transfusion practices in trauma Indian Journal of Anaesthesia Blood transfusion damage control resuscitation massive transfusion protocol packed red blood cells plasma platelets trauma resuscitation |
author_facet |
V Trichur Ramakrishnan Srihari Cattamanchi |
author_sort |
V Trichur Ramakrishnan |
title |
Transfusion practices in trauma |
title_short |
Transfusion practices in trauma |
title_full |
Transfusion practices in trauma |
title_fullStr |
Transfusion practices in trauma |
title_full_unstemmed |
Transfusion practices in trauma |
title_sort |
transfusion practices in trauma |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Anaesthesia |
issn |
0019-5049 |
publishDate |
2014-01-01 |
description |
Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury. |
topic |
Blood transfusion damage control resuscitation massive transfusion protocol packed red blood cells plasma platelets trauma resuscitation |
url |
http://www.ijaweb.org/article.asp?issn=0019-5049;year=2014;volume=58;issue=5;spage=609;epage=615;aulast=Ramakrishnan |
work_keys_str_mv |
AT vtrichurramakrishnan transfusionpracticesintrauma AT sriharicattamanchi transfusionpracticesintrauma |
_version_ |
1725760882186649600 |