Early high ratio platelet transfusion in trauma resuscitation and its outcomes

Ruben Peralta, Adarsh Vijay, Ayman El-Menyar, Rafael Consunji, Ibrahim Afifi, Ismail Mahmood, Mohammed Asim, Rifat - Latifi, Hassan Al-Thani

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Introduction: The optimal ratio of platelets (PLTs) to packed red blood cell (PRBC) in trauma patients requiring massive transfusion protocol (MTP) is still controversial. This report aims to describe the effect of attaining a high PLT:PRBC ratio (≥1:1.5) within 4 h postinjury on the outcomes of trauma patients receiving MTP. Methods: Over a 24-month period, records of all adult patients with traumatic injury who received MTP were retrospectively reviewed. Data were analyzed with respect to PLT:PRBC ratio ([high-MTP ≥1:1.5] [HMTP] vs. [low-MTP <1:1.5] [LMTP]) given within the first 4 h postinjury and also between (>4 and 24 h). Baseline demographic, clinical characteristics, complications, and outcomes were compared according to HMTP and LMTP. Results: Of the total 3244 trauma patients, PLT:PRBC ratio was attainable in 58 (1.2%) patients who fulfilled the inclusion criteria. The mean age was 32.3 ± 10.7 years; the majority were males (89.6%) with high mean Injury Severity Score (ISS): 31.9 ± 11.5 and Revise Trauma Score (RTS): 5.1 ± 2.2. There was no significant association between age, gender, type of injury, presenting hemoglobin, International Normalized Ratio, ISS, and RTS. The rate of ventilator-associated pneumonia (38.9% vs. 10.8%; P = 0.02) and wound infection (50% vs. 10.8%; P = 0.002) were significantly higher in the HMTP group. However, HMTP was associated with lower rate of multiple organ failure (MOF) (42.1% vs. 87.2%, P = 0.001) and mortality (36.8% vs. 84.6%, P = 0.001) within the first 30 days postinjury. Conclusions: Our study revealed that early attainment of high PLT/PRBC ratio within 4 h postinjury is significantly associated with lower MOF and mortality in trauma patients.

Original languageEnglish (US)
Pages (from-to)188-193
Number of pages6
JournalInternational Journal of Critical Illness and Injury Science
Volume6
Issue number4
DOIs
Publication statusPublished - Oct 1 2016

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Keywords

  • Complications
  • mortality
  • packed red blood cell
  • platelet
  • transfusion ratio
  • trauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Peralta, R., Vijay, A., El-Menyar, A., Consunji, R., Afifi, I., Mahmood, I., ... Al-Thani, H. (2016). Early high ratio platelet transfusion in trauma resuscitation and its outcomes. International Journal of Critical Illness and Injury Science, 6(4), 188-193. https://doi.org/10.4103/2229-5151.195448