Assessing response to changing plasma/red cell ratios in a bleeding trauma patient

Abstract Recent military experience suggests that transfusing fresh frozen plasma and packed red cells in a 1:1 ratio may improve survival in exsanguinating trauma patients. We report the case of a single patient who required massive transfusion after suffering a single gunshot wound. Initially, the...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of emergency medicine 2010, Vol.28 (1), p.120.e1-120.e5
Main Authors: Tien, Homer C., MD, MSc, Scarpellini, Sandro, MD, PhD, Callum, Jeannie, MD, Tremblay, Lorraine, MD, PhD, Rizoli, Sandro, MD, PhD
Format: Article
Language:English
Subjects:
Abdomen
Blood Coagulation Disorders - diagnosis
Blood Coagulation Disorders - etiology
Blood Coagulation Disorders - therapy
Blood Coagulation Tests
Blood Component Transfusion - methods
Blood platelets
Casualties
Emergency
Emergency medical care
Erythrocyte Transfusion
Fatal Outcome
Hemorrhage
Hemorrhage - etiology
Hemorrhage - therapy
Humans
Mathematical models
Pelvis
Plasma
Ratios
Wounds, Gunshot - complications
Wounds, Gunshot - therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Recent military experience suggests that transfusing fresh frozen plasma and packed red cells in a 1:1 ratio may improve survival in exsanguinating trauma patients. We report the case of a single patient who required massive transfusion after suffering a single gunshot wound. Initially, the patient received FFP:PRBC in 1:2 ratio, but this did not correct laboratory parameters except for INR and clotting factor VII level, which were likely normalized by treatment with recombinant activated factor VII. After receiving FFP:PRBC in a 4:5 ratio, he continued to bleed and his coagulation profile showed no appreciable improvement. In the final phase, he received FFP:PRBC in a 7:5 ratio and his laboratory parameters of coagulopathy normalized, except for factor V level which was improved. He also clinically stopped bleeding.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2009.04.027