Association of initial lactate levels and red blood cell transfusion strategy with outcomes after severe trauma: a post hoc analysis of the RESTRIC trial

The appropriateness of a restrictive transfusion strategy for those with active bleeding after traumatic injury remains uncertain. Given the association between tissue hypoxia and lactate levels, we hypothesized that the optimal transfusion strategy may differ based on lactate levels. This post hoc...

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Bibliographic Details
Published in:World journal of emergency surgery 2024-01, Vol.19 (1), p.1-1, Article 1
Main Authors: Kosaki, Yoshinori, Hongo, Takashi, Hayakawa, Mineji, Kudo, Daisuke, Kushimoto, Shigeki, Tagami, Takashi, Naito, Hiromichi, Nakao, Atsunori, Yumoto, Tetsuya
Format: Article
Language:English
Subjects:
Adult
Analysis
Blood
Blood Transfusion
Brain
Catecholamines
Erythrocyte Transfusion - adverse effects
Erythrocyte Transfusion - methods
Erythrocytes
Glycosylated hemoglobin
Hemoglobin
Hospitalization
Humans
Injuries
Intensive Care Units
Lactate
Lactates
Lactic Acid
Length of stay
Medical research
Medicine, Experimental
Mortality
Regression analysis
Trauma
Variables
Ventilators
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Summary:The appropriateness of a restrictive transfusion strategy for those with active bleeding after traumatic injury remains uncertain. Given the association between tissue hypoxia and lactate levels, we hypothesized that the optimal transfusion strategy may differ based on lactate levels. This post hoc analysis of the RESTRIC trial sought to investigate the association between transfusion strategies and patient outcomes based on initial lactate levels. We performed a post hoc analysis of the RESTRIC trial, a cluster-randomized, crossover, non-inferiority multicenter trials, comparing a restrictive and liberal red blood cell transfusion strategy for adult trauma patients at risk of major bleeding. This was conducted during the initial phase of trauma resuscitation; from emergency department arrival up to 7 days after hospital admission or intensive care unit (ICU) discharge. Patients were grouped by lactate levels at emergency department arrival: low (
ISSN:1749-7922
1749-7922
DOI:10.1186/s13017-023-00530-7