Mortality and Ratio of Blood Products Used in Patients With Severe Trauma

McCurdy, Michael T.; Liew-Spilger, Alyson; Walsh, Mark

doi:10.1001/jama.2015.4421

Cited by 11 publications

(12 citation statements)

References 5 publications

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“…† Time to "anatomic hemostasis" was 100 minutes according to the PROPPR trial. 2,71,72 patients, Donat Spahn has stated: "This is by no means to say that we should stop doing outcomes research on coagulation management in severely injured patients, but that we should not dismiss existing evidence in favour of TEG/ROTEM-based goal-directed individualized coagulation algorithms on the basis that we lack the ultimate 'perfect' study. As a matter of fact, today all hospitals should have an individualized and goal-directed coagulation algorithm: don't wait -act now!"…”

Section: Resultsmentioning

confidence: 99%

Tranexamic Acid for Trauma Resuscitation in the United States of America

Walsh

Thomas

Moore

et al. 2016

Semin Thromb Hemost

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The utilization of tranexamic acid (TXA) for the management of bleeding trauma patients has been a subject of much debate on both sides of the Atlantic and in Australia. As a result of the large randomized controlled study called the , there was an initial enthusiasm for the use of TXA to treat bleeding patients. However, the adoption of TXA in the United States was delayed by concerns of "knowledge and evidence gaps" of the CRASH-2 study and because of a lack of mechanistic rationale that would explain the survival benefit noted in the study. Subsequent nonrandomized controlled trials questioned the liberal use of TXA in trauma patients. This narrative review explores the historical as well as clinical and theoretical grounds for the more measured use of TXA in the United States and proposes a clinical and point-of-care guided utilization of TXA, blood components, and adjunctive hemostatic agents in bleeding trauma patients.

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Section: Resultsmentioning

confidence: 99%

Tranexamic Acid for Trauma Resuscitation in the United States of America

Walsh

Thomas

Moore

et al. 2016

Semin Thromb Hemost

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“…Clinical studies from combat resuscitation reveal that the patients who receive platelets early in massive transfusion and in higher ratios to packed red blood cells and fresh frozen plasma (FFP) have better outcomes (Holcomb et al , ). Subsequently, this clinical finding and the previous observation that trauma causes platelet dysfunction has been used to justify the concept of “platelet first” transfusion as part of massive transfusion protocols in the Pragmatic Randomised Optimal Platelet and Plasma Ratios (PROPPR) trial (Holcomb et al , ; McCurdy et al , ). Therefore, future study is necessary to determine whether the fresh and cold‐stored platelets participating in clot formation after resuscitation are in relation to their described heterogeneity of function in the circulation and within the core or surface of the clot of injury.…”

Section: Discussionmentioning

confidence: 99%

Platelets derived from fresh and cold‐stored whole blood participate in clot formation in rats with acute traumatic coagulopathy

Darlington

Montgomery

et al. 2017

Br J Haematol

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The in vitro haemostatic functions of fresh whole blood (FWB) are well preserved after cold storage. This study aimed to determine whether platelets derived from FWB and stored whole blood (SWB) contribute to clot formation in tissue injury after transfusion into coagulopathic rats with polytrauma/haemorrhage (T/H). The rats were resuscitated 1 h after trauma with FWB or SWB collected from green fluorescence protein (GFP) transgenic rats. After transfusion, a liver incision was made and the tissue was collected 10 min after injury to identify GFP platelets by immunohistochemistry. In comparison to FWB, platelet aggregation to adenosine diphosphate and protease-activated receptor-4 was reduced by 35% and 20%, and clotting time was shortened by 25% in SWB. After transfusion, SWB led to a significant increase in platelet activation as measured by an elevation of CD62P and phosphatidylserine expression. The platelets from SWB were in a higher activation state, and showed higher clearance rate and formation of platelet-leucocyte aggregates than those from FWB after transfusion. Platelets from both FWB and SWB were equivalently incorporated into the clot at the incisional site, as determined by co-localization of CD61 and GFP. This study suggests that SWB contributes to haemostatic function and is an effective alternative resource to treat trauma patients.

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“…However, the risk-to-benefit ratio of administering platelets based on platelet function assays remains an area of continued research. 6,79,80 TEG platelet mapping (TEG/PM), Multiplate, and ROTEM platelet analysis utilize different methodologies to evaluate isolated platelet dysfunction. 31,77,81,82 This remains an area of vigorous research because platelet dysfunction measured in circulating blood may not reveal the functionality of platelets at the core of the clot.…”

Section: Ct/r: Detection For the Need For Factor Replacement With Ffpmentioning

confidence: 99%

Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

Hartmann

Walsh

Grisoli

et al. 2020

Semin Thromb Hemost

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This article explores the application of viscoelastic tests (VETs) in trauma-induced coagulopathy and trauma resuscitation. We describe the advantages of VETs over conventional coagulation tests in the trauma setting and refer to previous disciplines in which VET use has reduced blood product utilization, guided prohemostatic agents, and improved clinical outcomes such as the mortality of critically bleeding patients. We describe different VETs and provide guidance for blood component therapy and prohemostatic therapy based on specific VET parameters. Because the two most commonly used VET systems, rotational thromboelastometry and thromboelastography, use different activators and have different terminologies, this practical narrative review will directly compare and contrast these two VETs to help the clinician easily interpret either and use the interpretation to determine hemostatic integrity in the bleeding trauma patient. Finally, we anticipate the future of new viscoelastic technologies that can be used in this setting.

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Mortality and Ratio of Blood Products Used in Patients With Severe Trauma

Cited by 11 publications

References 5 publications

Tranexamic Acid for Trauma Resuscitation in the United States of America

Tranexamic Acid for Trauma Resuscitation in the United States of America

Platelets derived from fresh and cold‐stored whole blood participate in clot formation in rats with acute traumatic coagulopathy

Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

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