The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: Comparative effectiveness of a time-varying treatment with competing risks
John B. Holcomb,Deborah J. del Junco,Erin E. Fox,Charles E. Wade,Mitchell J. Cohen,Martin A. Schreiber,Louis H. Alarcon,Yu Bai,Karen J. Brasel,Eileen M. Bulger,Bryan A. Cotton,Nena Matijevic,Peter Muskat,John G. Myers,Herb A. Phelan,Christopher E. White,Jiajie Zhang,Mohammad H. Rahbar +17 more
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Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission, and among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or Platelet ratios.Abstract:
Objective To relate in-hospital mortality to early transfusion of plasma and/or platelets and to time-varying plasma:red blood cell (RBC) and platelet:RBC ratios. Design Prospective cohort study documenting the timing of transfusions during active resuscitation and patient outcomes. Data were analyzed using time-dependent proportional hazards models. Setting Ten US level I trauma centers. Patients Adult trauma patients surviving for 30 minutes after admission who received a transfusion of at least 1 unit of RBCs within 6 hours of admission (n = 1245, the original study group) and at least 3 total units (of RBCs, plasma, or platelets) within 24 hours (n = 905, the analysis group). Main Outcome Measure In-hospital mortality. Results Plasma:RBC and platelet:RBC ratios were not constant during the first 24 hours (P Conclusions Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission. Among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or platelet ratios.read more
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Novel concepts for damage control resuscitation in trauma.
TL;DR: In the face of hemorrhagic shock from traumatic injury, resuscitation should be initiated with 1 : 1:1 transfusion of plasma, platelets, and red blood cells with limited to no use of crystalloids.
Journal ArticleDOI
Platelets regulate vascular endothelial stability: assessing the storage lesion and donor variability of apheresis platelets.
Gyulnar Baimukanova,Byron Miyazawa,Daniel R. Potter,Marcus O. Muench,Roberta Bruhn,Stuart L. Gibb,Philip C. Spinella,Andrew P. Cap,Mitchell J. Cohen,Shibani Pati,Shibani Pati +10 more
TL;DR: In current blood banking practices, platelets (PLTs) are stored in plasma at 22°C, with gentle agitation for up to 5 days, with the effects of storage and donor variability on PLT regulation of vascular integrity not known.
Journal ArticleDOI
Large volume transfusion with whole blood is safe compared with component therapy.
Jared R. Gallaher,Alexandra Dixon,April Cockcroft,Maverick Grey,Elizabeth N. Dewey,Andrew Goodman,Martin A. Schreiber +6 more
TL;DR: Transfusion utilizing primarily WB in civilian trauma is feasible, even in large volumes and appears to be a safe and effective addition to component therapy and may lead to a more balanced resuscitation but with more overall product used.
Journal ArticleDOI
RBC Transfusion Strategies in the ICU: A Concise Review.
TL;DR: The current literature supports the use of restrictive transfusion strategies in the majority of critically ill populations, with a focus on hemoglobin transfusion thresholds in the ICU.
Journal ArticleDOI
The 'procoagulopathy' of trauma: too much, too late?
Anthony Holley,Michael C. Reade +1 more
TL;DR: Viscoelastic measurement of developing clot strength identifies a procoagulant state in many trauma patients, and may be a guide to the best choice of the many options for thromboembolic prophylaxis.
References
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Erik von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
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Erik von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
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The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies
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