TAILIEUCHUNG - Báo cáo y học: "Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. | Schõchl et al. Critical Care 2011 15 R83 http content 15 2 R83 KS CRITICAL CARE RESEARCH Open Access Transfusion in trauma thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy Herbert Schochl1 2 Ulrike Nienaber3 Marc Maegele4 Gerald Hochleitner5 Florian Primavesi2 Beatrice Steitz6 Christian Arndt7 Alexander Hanke8 Wolfgang Voelckel2 and Cristina Solomon6 Abstract Introduction Thromboelastometry TEM -guided haemostatic therapy with fibrinogen concentrate and prothrombin complex concentrate PCC in trauma patients may reduce the need for transfusion of red blood cells RBC or platelet concentrate compared with fresh frozen plasma FFP -based haemostatic therapy. Methods This retrospective analysis compared patients from the Salzburg Trauma Centre Salzburg Austria treated with fibrinogen concentrate and or PCC but no FFP fibrinogen-PCC group n 80 and patients from the TraumaRegister DGU receiving 2 units of FFP but no fibrinogen concentrate PCC FFP group n 601 . Inclusion criteria were age 18-70 years base deficit at admission 2 mmol L injury severity score ISS 16 abbreviated injury scale for thorax and or abdomen and or extremity 3 and for head neck 5. Results For haemostatic therapy in the emergency room and during surgery the FFP group ISS received a median of 6 units of FFP range 2 51 while the fibrinogen-PCC group ISS received medians of 6 g of fibrinogen concentrate range 0 15 and 1200 U of PCC range 0 6600 . RBC transfusion was avoided in 29 of patients in the fibrinogen-PCC group compared with only 3 in the FFP group P . Transfusion of platelet concentrate was avoided in 91 of patients in the fibrinogen-PCC group compared with 56 in the FFP group P . Mortality was comparable between groups in the fibrinogen-PCC group and in the FFP group P . Conclusions TEM-guided haemostatic therapy with fibrinogen concentrate and PCC reduced the exposure

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