Pre-hospital plasma transfusion: a valuable coagulation support or an expensive fluid therapy?

Fenger-Eriksen, Christian; Fries, Dietmar; David, Jean-Stéphane; Bouzat, Pierre; Lancé, Marcus D.; Grottke, Oliver; Spahn, Donat R.; Schöechl, Herbert; Maegele, Marc

doi:10.1186/s13054-019-2524-4

Cited by 19 publications

(19 citation statements)

References 12 publications

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“…96,97 Limitations of the PAMPer trial are a relatively low Injury Severity Score (ISS) of 21, recruitment based on a single blood pressure of hypotension in the field or helicopter, few patients with demonstrated coagulopathy, and higher crystalloid administration in control patients. 84,96,97 Furthermore, despite low ISS of the patients in the COMBAT and PAMPer trials, mortality was very high compared with the results from the German trauma registry. 98 European centers do not use prehospital blood products with such frequency.…”

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 88%

“…Now, across the Atlantic and worldwide, there is increasing interest in using VETs to guide BCT in trauma. 25,28,56,[59][60][61][62][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87] As opposed to the recent emphasis on prehospital blood component administration in the United States, the European guidelines concerning trauma resuscitation have evolved; the current 2019 European Trauma Guidelines highlight VET-guided BCT. 85 In Europe, VET analysis is typically accomplished with rotational thromboelastometry (ROTEM), whereas in the United States, it is usually accomplished with thromboelastography (TEG).…”

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 99%

“…Specialized, highly centralized, efficient trauma centers in Austria, Germany, and Switzerland have published RCTs demonstrating improved mortality for patients with severe traumatic injuries treated in a goal-directed fashion with concentrates and PRBCs (►Table 3). 27,[78][79][80][81]84,85,90,91 United States' Recent Adoption of WB for Civilian Trauma Resuscitation…”

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 99%

“…More clearly defined studies are necessary to justify logistics and costs associated with prehospital blood product transfusion." 84 Other studies have failed to show benefit of prehospital administration of blood products in the civilian urban environment. 90,100,101 Rijnhout et al's review reports literature that suggests that prehospital blood transfusion with the simultaneous use of both PRBCs and plasma resulted in a significant reduction in the odds for long-term mortality but not short-term 24-hour mortality.…”

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 99%

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Whole Blood for Civilian Urban Trauma Resuscitation: Historical, Present, and Future Considerations

Walsh

Fries

Moore

et al. 2020

Semin Thromb Hemost

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Whole blood (WB) has been used for more than a century for far-forward combat resuscitation. Following the Iraq/Afghanistan combat, maritime, and austere environment use of WB for the resuscitation of severely hemorrhaging patients, there has been an increasing use of WB for the civilian urban resuscitation environment population. The impetus for this was not just improved outcomes in far-forward hospitals, which had different populations and different needs than the civilian urban population, but also an application of the lessons suggested by recent 1:1:1 plasma:platelets:packed red cells fixed-ratio studies for patients with massive transfusion needs. Mechanistic, logistic, and standardization concerns have been addressed and are evolving as the WB project advances. A small number of studies have been published on WB in the civilian urban trauma population. In addition, European experience with viscoelastic testing and resuscitation with fibrinogen and prothrombin complex concentrate has provided another viewpoint regarding the choice of resuscitation strategies for severely bleeding trauma patients in urban civilian environments. There are randomized controlled trials in process, which are testing the hypothesis that WB may be beneficial for the civilian urban population. Whether WB will improve mortality significantly is now a matter of intense study, and this commentary reviews the history, mechanistic foundations, and logistical aspects for the use of WB in the civilian trauma population.

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Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 88%

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 99%

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 99%

Section: International Trends In Trauma Resuscitation and The Use Of Wbmentioning

confidence: 99%

See 2 more Smart Citations

Whole Blood for Civilian Urban Trauma Resuscitation: Historical, Present, and Future Considerations

Walsh

Fries

Moore

et al. 2020

Semin Thromb Hemost

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“…Significant advances in hemorrhage control and hemostatic resuscitation have been made with the emergence of a new paradigm referred to as 'damage control resuscitation' [13]. Transfusion of existing blood products (i.e., red blood cells, fresh frozen plasma, platelets) for trauma has been conducted and has been shown to be logistically achievable without serious incident in prehospital settings, although no definitive conclusions as to any improved outcomes can be made given the low level of evidence [14][15][16][17]. In addition, new hemostatic agents, surgical adjuncts and blood products have been developed for prehospital control of life-threatening noncompressible hemorrhage from the splanchnic and junctional regions [14,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Hemostatic agents for prehospital hemorrhage control: a narrative review

Peng

2020

Military Med Res

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Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma. A significant number of deaths due to hemorrhage occur before and in the first hour after hospital arrival. A literature search was performed through PubMed, Scopus, and Institute of Scientific Information databases for English language articles using terms relating to hemostatic agents, prehospital, battlefield or combat dressings, and prehospital hemostatic resuscitation, followed by cross-reference searching. Abstracts were screened to determine relevance and whether appropriate further review of the original articles was warranted. Based on these findings, this paper provides a review of a variety of hemostatic agents ranging from clinically approved products for human use to newly developed concepts with great potential for use in prehospital settings. These hemostatic agents can be administered either systemically or locally to stop bleeding through different mechanisms of action. Comparisons of current hemostatic products and further directions for prehospital hemorrhage control are also discussed.

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