Is there a role for aggressive use of fresh frozen plasma in massive transfusion of civilian trauma patients?

Frederick A. Moore, Teresa Nelson, Bruce A. McKinley, Ernest E. Moore, Avery B. Nathens, Peter M Rhee, Juan Carlos Puyana, Gregory J. Beilman, Stephen M. Cohn

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Damage control resuscitation (DCR) with early plasma in combat casualties requiring massive transfusion (MT) decreases early deaths from bleeding. Methods: To ascertain the potential role of early plasma DCR in civilian MT, we queried a prospective traumatic shock database of 383 civilians. Results: Ninety-three (24%) of the traumatic shock civilians received a MT, of which 26 (28%) died early, predominantly from bleeding within 6 hours. Comparatively, this early MT death cohort arrived in more severe shock and were coagulopathic (mean INR 2.4). In the critical period of MT (ie, the first 3 hours), these patients received 20 U of packed red blood cells (PRBCs) but only 4 U of fresh frozen plasma (FFP). They remained severely acidotic and their coagulopathy worsened as they exsanquinated. Conclusion: Civilians who arrived in traumatic shock, required a MT, and died early had worsening coagulopathy, which was not treated. DCR with FFP may have a role in civilian trauma.

Original languageEnglish (US)
Pages (from-to)948-960
Number of pages13
JournalAmerican Journal of Surgery
Volume196
Issue number6
DOIs
StatePublished - Dec 2008
Externally publishedYes

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Traumatic Shock
Resuscitation
Wounds and Injuries
Hemorrhage
International Normalized Ratio
Shock
Erythrocytes
Databases

Keywords

  • Coagulopathy
  • Massive transfusion
  • Multiple organ failure
  • StO
  • Tissue hemoglobin oxygen saturation
  • Traumatic shock

ASJC Scopus subject areas

  • Surgery

Cite this

Is there a role for aggressive use of fresh frozen plasma in massive transfusion of civilian trauma patients? / Moore, Frederick A.; Nelson, Teresa; McKinley, Bruce A.; Moore, Ernest E.; Nathens, Avery B.; Rhee, Peter M; Puyana, Juan Carlos; Beilman, Gregory J.; Cohn, Stephen M.

In: American Journal of Surgery, Vol. 196, No. 6, 12.2008, p. 948-960.

Research output: Contribution to journalArticle

Moore, FA, Nelson, T, McKinley, BA, Moore, EE, Nathens, AB, Rhee, PM, Puyana, JC, Beilman, GJ & Cohn, SM 2008, 'Is there a role for aggressive use of fresh frozen plasma in massive transfusion of civilian trauma patients?', American Journal of Surgery, vol. 196, no. 6, pp. 948-960. https://doi.org/10.1016/j.amjsurg.2008.07.043
Moore, Frederick A. ; Nelson, Teresa ; McKinley, Bruce A. ; Moore, Ernest E. ; Nathens, Avery B. ; Rhee, Peter M ; Puyana, Juan Carlos ; Beilman, Gregory J. ; Cohn, Stephen M. / Is there a role for aggressive use of fresh frozen plasma in massive transfusion of civilian trauma patients?. In: American Journal of Surgery. 2008 ; Vol. 196, No. 6. pp. 948-960.
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