The Use of Whole Blood in Rural Trauma Leads to Decreased Resource Utilization
| العنوان: | The Use of Whole Blood in Rural Trauma Leads to Decreased Resource Utilization |
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| المؤلفون: | Britney R. Niemann, Daniel J. Grabo, Cody Mullens, Aaron D. Shmookler, Santiago Lopez, Owen M. Lander, Peter L. Griffin, James M. Bardes |
| المصدر: | The American Surgeon. :000313482211425 |
| بيانات النشر: | SAGE Publications, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | General Medicine |
| الوصف: | Background Nearly 40% of trauma deaths result from uncontrolled hemorrhage. Most of these deaths occur within 24 hours, highlighting the importance of early resuscitation. Balanced component resuscitation has been shown to improve outcomes in hemorrhagic shock. However, hemostatic properties may then be decreased, leading to inadequate coagulopathy treatment or higher transfusion requirements. Data comparing the efficacy of component vs. whole blood (WB) resuscitation in early trauma is poor, particularly in the rural population. This study investigates WB use and resource utilization at a rural Level 1 trauma center. Methods A prospective cohort study with historical controls (HC) was performed using patients over age 17 presenting as the highest priority trauma. Two units of WB were available to patients with signs of hemorrhagic shock, with subsequent transfusions via massive transfusion protocol or thromboelastography guidance. Component utilization, time to hemorrhage control, complications, and transfer times were examined. Results Forty patients received WB vs. 153 HC. WB patients had lower complication rates (35% vs. 55.6%; P = .02), and a significant reduction in pRBC utilization in the emergency department (0 vs. 2; P < .0001) and throughout admission (2.0 vs. 4.0; P = .0003). All patients had prolonged transport times given the rural setting (1.42 hours HC vs. 2.03 hours WB; P = .002). Discussion Unlike most urban WB studies, this study occurred in a rural area with extended transportation times, when WB is inaccessible for patients. Despite this delay, WB patients demonstrated lower component utilization and complication rates. Further research is needed to characterize the impact of early WB access. |
| تدمد: | 1555-9823 0003-1348 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2045b50263aa4be366d90dbf378b69db https://doi.org/10.1177/00031348221142584 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....2045b50263aa4be366d90dbf378b69db |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15559823 00031348 |
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