Prehospital whole blood reduces early mortality in patients with hemorrhagic shock
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Le résumé fourni par la source
BACKGROUND: Low titer O+ whole blood (LTOWB) is being increasingly used for resuscitation of hemorrhagic shock in military and civilian settings. The objective of this study was to identify the impact of prehospital LTOWB on survival for patients in shock receiving prehospital LTOWB transfusion. STUDY DESIGN AND METHODS: A single institutional trauma registry was queried for patients undergoing prehospital transfusion between 2015 and 2019. Patients were stratified based on prehospital LTOWB transfusion (PHT) or no prehospital transfusion (NT). Outcomes measured included emergency department (ED), 6-h and hospital mortality, change in shock index (SI), and incidence of massive transfusion. Statistical analyses were performed. RESULTS: A total of 538 patients met inclusion criteria. Patients undergoing PHT had worse shock physiology (median SI 1.25 vs. 0.95, p < .001) with greater reversal of shock upon arrival (-0.28 vs. -0.002, p < .001). In a propensity-matched group of 214 patients with prehospital shock, 58 patients underwent PHT and 156 did not. Demographics were similar between the groups. Mean improvement in SI between scene and ED was greatest for patients in the PHT group with a lower trauma bay mortality (0% vs. 7%, p = .04). No survival benefit for patients in prehospital cardiac arrest receiving LTOWB was found (p > .05). DISCUSSION: This study demonstrated that trauma patients who received prehospital LTOWB transfusion had a greater improvement in SI and a reduction in early mortality. Patient with prehospital cardiac arrest did not have an improvement in survival. These findings support LTOWB use in the prehospital setting. Further multi-institutional prospective studies are needed.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Prehospital whole blood reduces early mortality in patients with hemorrhagic shock
- Date Crossref
- 01/07/2021
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Texas at San Antonio Health Science Center pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas Health Science Center at Houston pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas at San Antonio pays non établi dans la noticeUniversité ou école supérieure
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Urology San Antonio pays non établi dans la noticeÉtablissement de santé
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South Texas Blood and Tissue Center pays non établi dans la noticeOrganisation à but non lucratif
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Department of Surgery UT Health San Antonio San Antonio Texas USA pays non établi dans la noticeInstitution
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Trauma Services University Hospital San Antonio Texas USA Trauma Services pays non établi dans la noticeUniversité ou école supérieure
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Southwest Texas Regional Advisory Council San Antonio Texas USA pays non établi dans la noticeInstitution
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Department of Emergency Health Services UT Health San Antonio San Antonio Texas USA pays non établi dans la noticeInstitution
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South Texas Blood & pays non établi dans la noticeInstitution
The University of Texas at San Antonio Health Science Center, The University of Texas Health Science Center at Houston et The University of Texas at San Antonio, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.