Admission Ionized Calcium Levels Predict the Need for Multiple Transfusions: A Prospective Study of 591 Critically Ill Trauma Patients

Magnotti, Louis J.; Bradburn, Eric H.; Webb, David L.; Berry, Stepheny; Fischer, Peter; Zarzaur, Ben L.; Schroeppel, Thomas J.; Fabian, Timothy C.; Croce, Martin A.

doi:10.1097/ta.0b013e31820b5d98

Cited by 76 publications

(106 citation statements)

References 23 publications

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“…31,32 Some of these instruments are specific to certain types of trauma such as penetrating chest injuries. 11 Some scores have assessed blood loss based on visual estimates, 33,34 ionic calcium values upon admission, 35 and derived secondary hemodynamic parameters. 36 The decision to apply the predictive scores considered in our study was based on their calculating options, on the recommendations of different internationals scientific societies, 14 and on their suitability to the type of population involved (civilian in our case).…”

Section: Discussionmentioning

confidence: 99%

Massive transfusion predictive scores in trauma. Experience of a transfusion registry

Chico‐Fernández

García-Fuentes

Alonso-Fernández

et al. 2011

Medicina Intensiva (English Edition)

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Section: Discussionmentioning

confidence: 99%

Massive transfusion predictive scores in trauma. Experience of a transfusion registry

Chico‐Fernández

García-Fuentes

Alonso-Fernández

et al. 2011

Medicina Intensiva (English Edition)

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“…En el contexto del paciente sangrante, los niveles plasmáticos bajos de calcio al ingreso hospitalario podrían estar relacionados con la necesidad de TM 217,218 .…”

Section: Aplicación De Otras Medidas Y Situaciones Especialesunclassified

“…Recomendación 45 6,41,93,[216][217][218] . Se recomienda monitorizar los niveles plasmáticos de calcio en el paciente sangrante (1C).…”

Section: Aplicación De Otras Medidas Y Situaciones Especialesunclassified

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Documento multidisciplinar de consenso sobre el manejo de la hemorragia masiva (documento HEMOMAS)

et al. 2015

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“…Low levels of ionized calcium at admission are associated with increased mortality and an increased requirement for massive transfusion [61,62]. Citrate, which is used as an anticoagulant in blood product components, chelates calcium and exacerbates the hypocalcemia, particularly when used in the FFP.…”

Section: Calciummentioning

confidence: 99%

Damage control resuscitation: a practical approach for severely hemorrhagic patients and its effects on trauma surgery

Mizobata

2017

j intensive care

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Coagulopathy observed in trauma patients was thought to be a resuscitation-associated phenomenon. The replacement of lost and consumed coagulation factors was the mainstay in the resuscitation of hemorrhagic shock for many decades. Twenty years ago, damage control surgery (DCS) was implemented to challenge the coagulopathy of trauma. It consists of three steps: abbreviated surgery to control the hemorrhage and contamination, resuscitation in the intensive care unit (ICU), and planned re-operation with definitive surgery. The resuscitation strategy of DCS focused on the rapid reversal of acidosis and prevention of hypothermia through the first two steps. However, direct treatment of coagulopathy was not emphasized in DCS. Recently, better understanding of the pathophysiology of coagulopathy in trauma patients has led to the logical opinion that we should directly address this coagulopathy during major trauma resuscitation. Damage control resuscitation (DCR), the strategic approach to the trauma patient who presents in extremis, consists of balanced resuscitation, hemostatic resuscitation, and prevention of acidosis, hypothermia, and hypocalcemia. In balanced resuscitation, fluid administration is restricted and hypotension is allowed until definitive hemostatic measures begin. The administration of blood products consisting of fresh frozen plasma, packed red blood cells, and platelets, the ratio of which resembles whole blood, is recommended early in the resuscitation. DCR strategy is now the most beneficial measure available to address trauma-induced coagulopathy, and it can change the treatment strategy of trauma patients. DCS is now incorporated as a component of DCR. DCR as a structured intervention begins immediately after rapid initial assessment in the emergency room and progresses through the operating theater into the ICU in combination with DCS. By starting from ground zero with the performance of DCS, DCR allows the trauma surgeon to correct the coagulopathy of trauma. The effect of the reversal of coagulopathy in massively hemorrhagic patients may change the operative strategy with DCS.

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Admission Ionized Calcium Levels Predict the Need for Multiple Transfusions: A Prospective Study of 591 Critically Ill Trauma Patients

Cited by 76 publications

References 23 publications

Massive transfusion predictive scores in trauma. Experience of a transfusion registry

Massive transfusion predictive scores in trauma. Experience of a transfusion registry

Documento multidisciplinar de consenso sobre el manejo de la hemorragia masiva (documento HEMOMAS)

Damage control resuscitation: a practical approach for severely hemorrhagic patients and its effects on trauma surgery

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