Are we giving enough coagulation factors during major trauma resuscitation?

Abstract:

:Hemorrhage is a major cause of trauma deaths. Coagulopathy exacerbates hemorrhage and is commonly seen during major trauma resuscitation, suggesting that current practice of coagulation factor transfusion is inadequate. Reversal of coagulopathy involves normalization of body temperature, elimination of the causes of disseminated intravascular coagulation (DIC), and transfusion with fresh-frozen plasma (FFP), platelets, and cryoprecipitate. Transfusion should be guided by clinical factors and laboratory results. However, in major trauma, clinical signs may be obscured and various factors conspire to make it difficult to provide the best transfusion therapy. Existing empiric transfusion strategies for, and prevailing teachings on, FFP transfusion appear to be based on old studies involving elective patients transfused with whole blood and may not be applicable to trauma patients in the era of transfusion with packed red blood cells (PRBCs). Perpetuation of such concepts is in part responsible for the common finding of refractory coagulopathy in major trauma patients today. In this review, we argue that coagulopathy can best be avoided or reversed when severe trauma victims are transfused with at least the equivalent of whole blood in a timely fashion.

journal_name

Am J Surg

authors

Ho AM,Karmakar MK,Dion PW

doi

10.1016/j.amjsurg.2005.03.034

subject

Has Abstract

pub_date

2005-09-01 00:00:00

pages

479-84

issue

3

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(05)00502-7

journal_volume

190

pub_type

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