Abstract
Background
Damage control resuscitation (DCR) with early plasma in combat casualties requiring
massive transfusion (MT) decreases early deaths from bleeding.
Methods
To ascertain the potential role of early plasma DCR in civilian MT, we queried a prospective
traumatic shock database of 383 civilians.
Results
Ninety-three (24%) of the traumatic shock civilians received a MT, of which 26 (28%)
died early, predominantly from bleeding within 6 hours. Comparatively, this early
MT death cohort arrived in more severe shock and were coagulopathic (mean INR 2.4).
In the critical period of MT (ie, the first 3 hours), these patients received 20 U
of packed red blood cells (PRBCs) but only 4 U of fresh frozen plasma (FFP). They
remained severely acidotic and their coagulopathy worsened as they exsanquinated.
Conclusion
Civilians who arrived in traumatic shock, required a MT, and died early had worsening
coagulopathy, which was not treated. DCR with FFP may have a role in civilian trauma.
Keywords
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Article info
Publication history
Received in revised form:
June 13,
2008
Received:
April 22,
2008
Footnotes
This study was funded by Hutchinson Technology Inc, Hutchinson, MN.
Identification
Copyright
© 2008 Published by Elsevier Inc.
