Damage control resuscitation: history, theory and technique

Ball, Chad G.

doi:10.1503/cjs.020312

Cited by 114 publications

(90 citation statements)

References 60 publications

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“…The early transfusion of blood products, often as part of a massive transfusion protocol, and the avoidance of large volume crystalloid resuscitations has become the standard of care in critically ill patients. 37 Research into the impact of the age of stored RBCs in a variety of patient populations has evolved over the past decade. Studies from the cardiac surgery literature have generally shown mixed results; however, several large retrospective studies have demonstrated increased mortality in patients transfused with older blood.…”

Section: Discussionmentioning

confidence: 99%

Impact of the age of stored blood on trauma patient mortality: a systematic review

et al. 2015

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Background:The impact of the age of stored red blood cells on mortality in patients sustaining traumatic injuries requiring transfusion of blood products is unknown. The objective of this systematic review was to identify and describe the available literature on the use of older versus newer blood in trauma patient populations. Methods:We searched PubMed, Embase, Lilac and the Cochrane Database for published studies comparing the transfusion of newer versus older red blood cells in adult patients sustaining traumatic injuries. Studies included for review reported on trauma patients receiving transfusions of packed red blood cells, identified the age of stored blood that was transfused and reported patient mortality as an end point. We extracted data using a standardized form and assessed study quality using the Newcastle-Ottawa Scale.Results: Seven studies were identified (6780 patients) from 3936 initial search results. Four studies reported that transfusion of older blood was independently associated with increased mortality in trauma patients, while 3 studies did not observe any increase in patient mortality with the use of older versus newer blood. Three studies associated the transfusion of older blood with adverse patient outcomes, including longer stay in the intensive care unit, complicated sepsis, pneumonia and renal dys function. Studies varied considerably in design, volumes of blood transfused and def initions applied for old and new blood. Conclusion:The impact of the age of stored packed red blood cells on mortality in trauma patients is inconclusive. Future investigations are warranted.Contexte : On ne connaît pas l'incidence de la durée de stockage des globules rouges sur la mortalité des patients atteints de lésions traumatiques qui ont besoin de transfu sions de produits sanguins. L'objectif de cette revue systématique était de trouver et d'analyser la documentation scientifique qui compare les transfusions de sang chez les patients adultes victimes de trauma en fonction de la durée de stockage du sang.Méthodes : Nous avons effectué des recherches sur PubMed, Embase et Lilac et dans la Cochrane Database of Systematic Reviews. Les études retenues portaient sur des transfusions de concentré de globules rouges chez les patients atteints de lésions traumatiques, tenaient compte de la durée de stockage du sang transfusé et faisaient état des décès de patients. Nous avons extrait les données à l'aide d'un formulaire nor malisé et évalué la qualité des études selon l'échelle Newcastle-Ottawa.Résultats : Nous avons sélectionné 7 études (totalisant 6780 patients) parmi les 3936 ré sultats de la recherche initiale. D'un côté, 4 études rapportaient que la transfu sion de sang dont la durée de stockage était longue était indépendamment associée à l'augmentation de la mortalité chez les patients atteints de lésions traumatiques; de l'autre, 3 études ne faisaient état d'aucune augmentation de la mortalité en fonction de la durée de stockage du sang transfusé. Trois études associaient la transfusion de sang s...

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Section: Discussionmentioning

confidence: 99%

Impact of the age of stored blood on trauma patient mortality: a systematic review

et al. 2015

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“…Key components include permissive hypotension, preferential use of blood products over isotonic fl uids, and early correction of coagulopathy with goal-directed component therapy [ 33 , 61 ]. This early administration of blood products allows for prevention and treatment of coagulopathy and for the ability to temporize ongoing hemorrhage in order to restore blood volume and hemodynamic stability [ 62 ].…”

Section: Damage Control Resuscitationmentioning

confidence: 99%

“…This standardization helps to provide earlier administration of blood products during the resuscitation phase, improved overall effi ciency, and decreased total blood product use during a patient's hospital stay resulting in substantial economic savings [ 82 ]. Additionally, the amount of crystalloid infused is decreased, thus reducing dilutional coagulopathy [ 62 ]. Once hemorrhage is controlled, the MTP is discontinued and further transfusions guided by clinical and laboratory assessment.…”

Section: Implementation and Characteristics Of Centers With Mtpsmentioning

confidence: 99%

Massive Transfusion Protocols

Moren

Underwood

Schreiber

2016

Trauma Induced Coagulopathy

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“…19 These 2 dominant issues (operative case load and skill maintenance) have been significant factors in the development of ACS services in the United States. 8,[18][19][20] In Canada, one can make a similar argument that in centres where ACS is not directly integrated with the trauma service owing to volume concerns (most centres), maintenance of skills must be maintained by active involvement in a critical threshold of ACS service weeks and complex cases. The exception to this principle may potentially occur when an atypical trauma surgeon of note has a large, complex intra-abdominal elective practice.…”

Section: Yearmentioning

confidence: 99%