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BACKGROUND Trauma resuscitation has undergone a paradigm shift with new emphasis on the early use of blood products and increased proportions of plasma and platelets. However, it is unclear how this strategy is applied or how effective it is in the elderly population. The study aim is to identify differences in transfusion practices and the coagulopathy of trauma in the elderly. METHODS Data ...

BACKGROUND Coagulopathy is a consequence of severe trauma, especially in massively transfused patients (>or=10 units of red blood cells in 24 hours), and is associated with increased mortality. We hypothesized that recombinant factor VIIa (rFVIIa) administered to massive transfusion patients before transfusion of 8 units of blood (early) would reduce transfusion requirements compared with rFVII...

BACKGROUND There is no existing adequate blood transfusion needs determination tool that Emergency Medical Services (EMS) personnel can use for prehospital blood transfusion initiation. In this study, a simple and pragmatic prehospital blood transfusion needs scoring system was derived and validated. METHODS Local trauma registry data were reviewed retrospectively from 2004 through 2013. Pati...

BACKGROUND Major trauma patients are invariably received in the emergency department by a combination of emergency department and trauma team staff. The initial assessment is largely protocol led, using Advanced Trauma Life Support (ATLS) guidelines. The task of ordering and prescribing blood products often falls to the more junior members of this team. AIM The aim of this postal questionnair...

HYPOTHESIS Blood components undergo changes during storage that may affect the recipient, including the release of bioactive agents, with significant immune consequences. We hypothesized that transfusion of old blood increases infection risk in severely injured patients. DESIGN Prospective cohort study. SETTING Urban level I regional trauma center. PATIENTS Sixty-one trauma patients with ...

BACKGROUND Few studies have examined the impact of balanced resuscitation in pediatric trauma patients requiring massive transfusions. Adult data may not be generalizable to children. METHODS Retrospective analysis assessed patients seen at a level I trauma center between 2003 and 2010 aged ≤18 years requiring massive packed red blood cell (PRBC) transfusion, defined as transfusion of ≥50% to...

HYPOTHESIS The incidence and severity of postinjury multiple organ failure (MOF) has decreased over the last decade. DESIGN A prospective 12-year inception cohort study ending December 31, 2003. SETTING Regional academic level I trauma center. PATIENTS One thousand three hundred forty-four trauma patients at risk for postinjury MOF. Inclusion criteria were aged older than 15 years, admiss...

BACKGROUND AND OBJECTIVES The empiric use of a high plasma to packed red-blood-cell [fresh frozen plasma:red-blood-cells (FFP:RBC)] ratio in trauma resuscitation for patients with massive bleeding has become well accepted without clear or objective indications. Increased plasma transfusion is associated with worse outcome in some patient populations. While previous studies analyse only patients...

HYPOTHESIS Survival following massive transfusion in patients who have undergone trauma has improved during the past 10 years. DESIGN Retrospective cohort study. SETTING Academic level I trauma center in an urban community. PATIENTS All patients who underwent trauma and who received greater than 50 U of packed red blood cells or whole blood in the 48 hours following admission to the emerg...