Defining Present Blood Component Transfusion Practices in Trauma Patients: Papers From the Trauma Outcomes Group

2011 ◽  
Vol 71 ◽  
pp. S315-S317 ◽  
Author(s):  
John B. Holcomb ◽  
Charles E. Wade
Keyword(s):  
Blood Component ◽  
Trauma Patients ◽  
Trauma Outcomes ◽  
Blood Component Transfusion

scholarly journals Transfusion Strategies in the Pre-Hospital Setting: Evaluating the Logistical Benefits of Pre-Hospital Whole Blood Transfusion, and a National Survey of Pre-Hospital Blood Transfusion

2021 ◽  
Author(s):  
Harriet Tucker ◽  
Laura Green ◽  
Karim Brohi ◽  
Rebecca Cardigan ◽  
Ross Davenport ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
National Survey ◽  
Whole Blood ◽  
Hospital Setting ◽  
Flow Time ◽  
Transfusion Practice ◽  
Blood Component ◽  
Trauma Patients ◽  
Time Analysis ◽  
Blood Component Transfusion

Abstract BackgroundPre-hospital blood component transfusion poses logistical challenges. Current patterns of pre-hospital blood use across the UK are not known. A potential benefit of providing a single combined component of whole blood is reduced need for multiple steps of administering separate components and more efficient use of time and resources by medical staff. .Objectivesto undertake a detailed time-analysis of the steps of pre-hospital combined component transfusion against separate blood component transfusion, and to determine current UK pre-hospital transfusion practice and users’ optimal pre-hospital transfusion strategyMethodsA three-arm cross-over major haemorrhage simulation study compared: flow-time (time from decision-to-transfuse [DTT] to complete transfusion); touch-time (direct team ’hands on’ contact time with transfusion process); and number of steps, people and equipment required for transfusion of 2 units of RCP [arm-A], 2 RBC + 2 TP [arm-B] or RBC + 2 Lyoplas [arm-C]). A national survey of current and optimal pre-hospital transfusion strategies was sent to 22 UK Air Ambulance Services (AAS) and 27 Major Trauma Centres (MTC) in December 2019. ResultsThe simulation demonstrated that arm-A had a shorter flow-time (median 6min 31sec vs. 12min 20 sec, vs 16min 29 sec) and touch-time (median 2min 31 seconds vs. 5min 21sec vs. 15min 3sec) than arm-B and arm-C respectively, and required fewer steps, equipment and checks. 18 MTCs and 18 AAS responded to the national survey (response rates of 67 and 82%). 10 transfused RBC/plasma (5 TP/5 Lyoplas), 4 RBC only, 2 Lyoplas only, 1 RBC/Lyoplas/Fibrinogen, and 1 ’red cell and plasma’ (only available at one hospital site). 89% replied that a combined component transfusion would be desirable, as it would reduce patient mortality (83%) and tasks on scene (75%). ConclusionThe time-analysis established the benefits for combined pre-hospital component transfusion in trauma patients. The national survey demonstrates the variation in current pre-hospital transfusion practice and reiterates that combined component transfusion pre-hospital may have logistical advantages over separate components.

Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model

2017 ◽  
Vol 37 (2) ◽  
pp. 18-30 ◽  
Author(s):  
Allison R. Jones ◽  
Susan K. Frazier
Keyword(s):  
Conceptual Model ◽  
Traumatic Injury ◽  
Blood Component ◽  
Blood Components ◽  
Storage Lesion ◽  
Trauma Outcomes ◽  
Packed Red Blood Cells ◽  
Blood Component Transfusion ◽  
Patient’S Outcome

Transfusion of blood components is often required in resuscitation of patients with major trauma. Packed red blood cells and platelets break down and undergo chemical changes during storage (known as the storage lesion) that lead to an inflammatory response once the blood components are transfused to patients. Although some evidence supports a detrimental association between transfusion and a patient’s outcome, the mechanisms connecting transfusion of stored components to outcomes remain unclear. The purpose of this review is to provide critical care nurses with a conceptual model to facilitate understanding of the relationship between the storage lesion and patients’ outcomes after trauma; outcomes related to trauma, hemorrhage, and blood component transfusion are grouped according to those occurring in the short-term (≤30 days) and the long-term (>30 days). Complete understanding of these clinical implications is critical for practitioners in evaluating and treating patients given transfusions after traumatic injury.

Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

2020 ◽  
pp. 000313482096006
Author(s):  
William Q. Duong ◽  
Areg Grigorian ◽  
Cyrus Farzaneh ◽  
Jeffry Nahmias ◽  
Theresa Chin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Trauma Patients ◽  
Improvement Program ◽  
Trauma Outcomes ◽  
Risk Of Death ◽  
Hospital Access ◽  
Risk Of Mortality ◽  
Sex Disparities ◽  
Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

Quantification of Thrombelastographic Changes After Blood Component Transfusion in Patients with Liver Disease in the Intensive Care Unit

1995 ◽  
Vol 81 (2) ◽  
pp. 272-278
Author(s):  
Douglas G. Clayton ◽  
Adelaida M. Miro ◽  
David J. Kramer ◽  
Nathaniel Rodman ◽  
Stanley Wearden
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Disease ◽  
Blood Component ◽  
Blood Component Transfusion

National temporal variation in major trauma in England, Wales and Northern Ireland

Trauma ◽  
2021 ◽  
pp. 146040862098226
Author(s):  
Will Kieffer ◽  
Daniel Michalik ◽  
Jason Bernard ◽  
Omar Bouamra ◽  
Benedict Rogers
Keyword(s):  
Northern Ireland ◽  
Temporal Variation ◽  
Major Trauma ◽  
Injury Severity ◽  
Research Network ◽  
Trauma Patients ◽  
Trauma Outcomes ◽  
Causes Of Mortality ◽  
Injured Patients ◽  
Time Of Admission

Introduction Trauma is one of the leading causes of mortality worldwide, but little is known of the temporal variation in major trauma across England, Wales and Northern Ireland. Proper workforce and infrastructure planning requires identification of the caseload burden and its temporal variation. Materials and Methods The Trauma Audit Research Network (TARN) database for admissions attending Major Trauma Centres (MTCs) between 1st April 2011 and 31st March 2018 was analysed. TARN records data on all trauma patients admitted to hospital who are alive at the time of admission to hospital. Major trauma was classified as an Injury Severity Score (ISS) >15. Results A total of 158,440 cases were analysed. Case ascertainment was over 95% for 2013 onwards. There was a statistically significant variation in caseload by year (p < 0.0001), times of admissions (p < 0.0001), caseload admitted during weekends vs weekdays, 53% vs 47% (p < 0.0001), caseload by season with most patients admitted during summer (p < 0.0001). The ISS varied by time of admission with most patients admitted between 1800 and 0559 (p < 0.0001), weekend vs weekday with more severely injured patients admitted during the weekend (p < 0.0001) and by season p < 0.0001). Discussion and Conclusion: There is a significant national temporal variation in major trauma workload. The reasons are complex and there are multiple theories and confounding factors to explain it. This is the largest dataset for hospitals submitting to TARN which can help guide workforce and resource allocation to further improve trauma outcomes.

scholarly journals Activated clotting time of thrombelastography (T-ACT) predicts early postinjury blood component transfusion beyond plasma

Surgery ◽  
2014 ◽  
Vol 156 (3) ◽  
pp. 564-569 ◽  
Author(s):  
Hunter B. Moore ◽  
Ernest E. Moore ◽  
Theresa L. Chin ◽  
Eduardo Gonzalez ◽  
Michael P. Chapman ◽  
...  
Keyword(s):  
Blood Component ◽  
Clotting Time ◽  
Blood Component Transfusion ◽  
Activated Clotting Time

Noninfectious Complications of Blood Transfusion

2007 ◽  
Vol 131 (5) ◽  
pp. 708-718 ◽  
Author(s):  
Anne F. Eder ◽  
Linda A. Chambers
Keyword(s):  
Disease Transmission ◽  
English Language ◽  
Viral Disease ◽  
Late Complications ◽  
Blood Component ◽  
Red Cell ◽  
Blood Component Transfusion ◽  
Research And Education ◽  
Active Investigation ◽  
Complications Of Blood Transfusion

Abstract Context.—Serious noninfectious complications are far more likely to occur than viral disease transmission from blood component transfusion. Objective.—To compile a comprehensive list of the noninfectious risks of transfusion, examples of published risk estimates, and summaries of recent information regarding cause, prevention, or management of noninfectious transfusion risks. Data Sources.—Information was obtained from peer-reviewed English-language medical journal publications since 1990. Conclusions.—Early complications, although potentially more serious, usually occur less frequently (&lt;1 in 1000 transfusions) than late complications, which often affect more than 1% of recipients. Areas of active investigation and discussion include acute hemolytic reactions, transfusion-related acute lung injury, red cell alloimmunization, platelet transfusion refractoriness, and transfusion immunosuppression. Continued effort toward research and education to promote recognition and prevention of noninfectious complications associated with blood components is warranted.

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