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Signa vitae : journal for intesive care and emergency medicine, Vol. 9 No. Suppl. 1, 2014.

Original scientific paper

Transfusion in polytraumatised patients

DANIELA BANDIĆ PAVLOVIĆ ; Department of Anesthesiology and Intensive Care Unit, University Hospital Centre Zagreb, Zagreb, Croatia
SANJA SAKAN ; Department of Anesthesiology and Intensive Care Unit, University Hospital Centre Zagreb, Zagreb, Croatia
IGOR VIRAG ; Department of Anesthesiology and Intensive Care Unit, University Hospital Centre Zagreb, Zagreb, Croatia
ROBERT BARONICA ; Department of Anesthesiology and Intensive Care Unit, University Hospital Centre Zagreb, Zagreb, Croatia
ŽELJKO DRVAR ; Department of Anesthesiology and Intensive Care Unit, University Hospital Centre Zagreb, Zagreb, Croatia
MLADEN PERIĆ ; Department of Anesthesiology and Intensive Care Unit, University Hospital Centre Zagreb, Zagreb, Croatia
DINKO TONKOVIĆ ; Department of Anaesthesiology and Intensive Care Unit, University Hospital „Sveti Duh“, Zagreb, Croatia
ŽELJKA MARTINOVIĆ ; Ministry of Labour and Pension System, Zagreb, Croatia

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Abstract

Background and Aim. Recent evidence indicates that surgical bleeding due to injured vessels and traumatic coagulopathy
are the main reasons of uncontrolled haemorrhage in polytraumatized patients in the first 24 hours. The cornerstone of the
treatment is adequate empiric early transfusion. The aim of our study was to survey the early transfusion in patients with
major trauma and define the ratio of applied transfusion component in our hospital.
Patients and Methods: Patients with major trauma for a one year period, admitted to the Emergency Department of the
Clinical Hospital Centre, Zagreb, were enrolled in our retrospective study. The following data were collected: age, sex, mechanism
of injury, initial shock index (SI), initial Glasgow Coma Score (GCS), Injury severity score (ISS), and initial hemoglobin
(Hb) and prothrombin time (PT). Intra-operative transfusion and transfusion within the first 24 hours of injury, Intensive care
unit (ICU) stay and clinical outcome were assessed.
Results. 16 patients with major trauma were admitted. Eight patients received transfusions. Two patients received a massive
transfusion. The transfusion ratio of Fresh frozen plasma (FFP) : Packed red blood cells (PRBC) : Platelets (PLT) during
major trauma resuscitation was 1:1,5:1 in our study. One of the 16 patients died.
Conclusion. Early and aggressive resuscitation with transfusion blood products in major trauma patients within the first 24
hours with the FFP:PRBC:PLT ratio 1:1:1 is the key for prevention of trauma induced coagulopathy and its lethal consequences.
Massive transfusion protocol for major trauma patients should be implemented in everyday practice.

Keywords

abbreviated injury scales; blood component transfusion; injuries; polytrauma

Hrčak ID:

134144

URI

https://hrcak.srce.hr/134144

Publication date:

1.6.2014.

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