Early Predictors of Massive Transfusion in Patients Sustaining Torso Gunshot Wounds in a Civilian Level I Trauma Center
Early Predictors of Massive Transfusion in Patients Sustaining Torso Gunshot Wounds in a Civilian Level I Trauma Center
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DOI：
10.1097/ta.0b013e3181cf7f2a
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发表时间：
2010-02-01
影响因子：
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通讯作者：
Ingram, Walter L.
中科院分区：
文献类型：
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作者：
Dente, Christopher J.;Shaz, Beth H.;Ingram, Walter L.
背景：早期预测大量输血 (MT) 的需要仍然很困难。我们假设，通过识别需要早期输血和手术的躯干枪伤 (GSW) 中的 MT 标志物（24 小时内>10 个单位的红细胞 [PRBC]），可以提高 MT 方案 (MTP) 的利用率。方法：前瞻性收集 2007 年 2 月 1 日至 2009 年 1 月 31 日期间所有 MTP 的数据。对 MT 的人口统计、输血、解剖和手术数据进行了分析结果：在 216 例 MTP 激活中，78 例 (36%) 患者持续存在躯干 GSW，需要早期输血和手术。其中五人在接受 MT 之前已垂死挣扎并死亡。在 73 名早期幸存者中，56 人接受了 MT（76%，平均 19 个单位 PRBC），17 人接受了早期出血控制 (EBC)（24%，平均 5 个单位 PRBC）。无论初始血流动力学状态如何（平均收缩压：96 mm Hg；范围，50-169），12 个经盆腔伤口和 13 个多腔伤口均接受了 MT。在 31 名具有低风险轨迹 (LRT) 的 MT 患者中，18 名 (58%) 患有收缩压
Background: Early prediction of the need for massive transfusion (MT) remains difficult. We hypothesized that MT protocol (MTP) utilization would improve by identifying markers for MT (>10 units packed red blood cell [PRBC] in 24 hours) in torso gunshot wounds (GSW) requiring early transfusion and operation.Methods: Data from all MTPs were collected prospectively from February 1, 2007, to January 31, 2009. Demographic, transfusion, anatomic, and operative data were analyzed for MT predictors.Results: Of the 216 MTP activations, 78 (36%) patients sustained torso GSW requiring early transfusion and operation. Five were moribund and died before receiving MT. Of 73 early survivors, 56 received MT (76%, mean 19 units PRBC) and 17 had early bleeding control (EBC), (24%, mean 5 units PRBC). Twelve transpelvic and 13 multicavitary wounds all received MT regardless of initial hemodynamic status (mean systolic blood pressure: 96 mm Hg; range, 50-169). Of 31 MT patients with low-risk trajectories (LRT), 18 (58%) had a systolic blood pressure