Efficacy of transfusion of fresh frozen plasma and red blood cells in traumatic hemorrhagic shock
Keywords:
blood component transfusion, ; hemorrhagic shock, wounds and injuriesAbstract
Introduction: blood components are used to replace blood volume. However, some patients benefit more from the proportional use of fresh frozen plasma, red blood cells, platelets, cryoprecipitates, and prohemostatic drugs.
Objective: to evaluate the effectiveness of transfusion therapy with fresh frozen plasma and red blood cells in a 1:1 ratio in patients with traumatic hemorrhagic hypovolemic shock.
Methods: a pre-experimental study without a control group was carried out at the “Martín Chang Puga” General Teaching Hospital in Nuevitas, Camagüey province, between January 2019 and December 2022. It worked with a population of 27 patients undergoing emergency operations for traumatic hemorrhagic hypovolemic shock. The variables were evaluated: age, sex, shock classification according to the Advanced Trauma Life Support, amount of crystalloids administered, and topographic location of the trauma. Before and after transfusion therapy, the outcome variables were measured: international normalized ratio, base deficit, and lactate.
Results: male patients predominated; the most representative age was found in the group of 40 to 49 years (33.30 %). Cases of moderate hemorrhage predominated (14, of 27). International normalized ratio, base deficit, and lactate decreased significantly after hemotherapy.
Conclusions: proportional administration (1:1) of fresh frozen plasma and red blood cells was effective in the resuscitation of patients with traumatic hemorrhagic hypovolemic shock; their analytical values were normalized. The usefulness of this therapy to improve the international normalized index, base deficit, and serum lactate was evident.
Downloads
References
Yáñez JP, Calva M, Zepeda S, Garrido R, Fragoso-Avilés F. Resucitación hemostática en el paciente con choque hipovolémico hemorrágico. Reporte de un caso. Rev. chil. anest [Internet]. 2019 [citado 1 Jun 2023];48(3):262-9. Disponible en: https://revistachilenadeanestesia.cl/PII/revchilanestv48n03.11.pdf
Valdés-Rodríguez MF, Conde-Fernández BD, Rodríguez-Concepción JP, Betancourt-Cervantes JR, Velázquez-Chinea EM, Valdés-Rodríguez AM. Características de los pacientes con choque hemorrágico traumático. Rev. cuban. med. mil. [Internet]. Mar 2023 [citado 1 Jun 2023];52(1):e02302475. Disponible en: http://scielo.sld.cu/pdf/mil/v52n1/1561-3046-mil-52-01-e2475.pdf
Romero OM, Pociello-Llohan L. Uso de hemoderivados en la atención prehospitalaria en pacientes politraumáticos en shock hipovolémico. Npunto [Internet]. Ene 2022 [citado 1 Jun 2023];5(46):131-40. Disponible en: https://www.npunto.es/content/src/pdf-articulo/61f11cb9a3e7eart7.pdf
Caballero-López A, Domínguez-Perera MA, Pardo-Núñez AB, Abdo-Cuza AA, Ruiz-Hernández JR, Rodríguez-Monteagudo JL, et al. Terapia intensiva. Urgencias traumáticas. T.10 [Internet]. 3ra ed. La Habana: Editorial Ciencias Médicas; 2020 [citado 1 Jun 2023]. Disponible en: http://www.bvs.sld.cu/libros_texto/terapia_intensiva10_urgencias_traumaticas_terceraedicion/terapia_intensiva_tomo10.pdf
Ministerio de Salud Pública (Cuba). Anuario Estadístico de Salud 2021 [Internet]. La Habana: Dirección Nacional de Registros Médicos y Estadísticas de Salud; 2022 [citado 1 Jun 2023]. Disponible en: https://files.sld.cu/bvscuba/files/2023/10/Anuario-Estad%c3%adstico-de-Salud-2021.-Ed-2022_3.pdf
Jiménez-Vargas MF, Villalobos-Romero B, Quirós-Chaves K. Transfusión sanguínea masiva en shock hemorrágico. Rev. méd. sinerg [Internet]. 2022 [citado 1 Jun 2023];7(5):e795. Disponible en: https://revistamedicasinergia.com/index.php/rms/article/view/795
Valdés-Rodríguez MF, Rodríguez-Corvea L, Condes-Fernández BD, Orellana-Meneses GA. Predictores de mortalidad precoz en pacientes con trauma complejo hemorrágico. Gac Méd Espirit [Internet]. Ago 2022 [citado 1 Jun 2023];24(2):2428. Disponible en: http://scielo.sld.cu/pdf/gme/v24n2/1608-8921-gme-24-02-2428.pdf
Nieto-Pérez OR, Sánchez-Díaz JS, Solórzano-Guerra A, Márquez-Rosales E, García-Parra OF, Zamarrón-López EI, et al. Fluidoterapia intravenosa guiada por metas. Med. interna Méx [Internet]. Abr 2019 [citado 1 Jun 2023];35(2):235-50. Disponible en: https://www.scielo.org.mx/pdf/mim/v35n2/0186-4866-mim-35-02-235.pdf
Jiang S, Wu M, Lu X, Zhong Y, Kang X, Song Y, et al. Is restrictive fluid resuscitation beneficial not only for hemorrhagic shock but also for septic shock? A meta-analysis. Medicine (Baltimore [Internet]. 2021 [citado 1 Jun 2023];100(12):e25143. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282070/pdf/medi-100-e25143.pdf
Smart L, Hughes D. The effects of resuscitative fluid therapy on the endothelial surface layer. Front Vet Sci [Internet]. May 2021 [citado 1 Jun 2023];8:661660. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137965/pdf/fvets-08-661660.pdf
Martínez-Sánchez LM, Hernández-Martínez A, Roldan-Tabares MD, Herrera-Almanza L, Villegas-Alzate JD, Álvarez-Hernández LF. Hemocomponentes en urgencias: tratamiento vital para los pacientes politraumatizados. Rev Cubana Hematol Inmunol Hemoter [Internet]. Sep 2019 [citado 1 Jun 2023];35(3):e955. Disponible en: http://scielo.sld.cu/pdf/hih/v35n3/1561-2996-hih-35-03-e955.pdf
Kojima M, Endo A, Shiraishi A, Shoko T, Otomo Y, Coimbra R. Association between the plasma-to-red blood cell ratio and survival in geriatric and non-geriatric trauma patients undergoing massive transfusion: a retrospective cohort study. J Intensive Care [Internet]. 2022 [citado 1 Jun 2023];10(1):2. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753889/pdf/40560_2022_Article_595.pdf
Cruz-Cruz BL, Pérez-Chávez F, Cázares-Tamez R, Mercado-Del Ángel F. Coagulopatía y manejo de hemocomponentes en pacientes con transfusión masiva en un hospital universitario. Rev Mex Med Tran [Internet]. Dic 2018 [citado 31 May 2023];11(1):5-10. Disponible en: https://www.medigraphic.com/pdfs/transfusional/mt-2018/mt181a.pdf
Asociación Médica Mundial. Declaración de Helsinki de la AMM. Principios éticos para las investigaciones médicas en seres humanos. Ratificada en la 64ª Asamblea General, Fortaleza, Brasil, octubre 2013. Helsinki: 18ª Asamblea Mundial; 1964 [citado 12 Abr 2020]. Disponible en: http://www.anmat.gov.ar/comunicados/HELSINSKI_2013.pdf
Ramos JP, Ottolino PR, Muñoz CA, Ruíz JE, Arenas CE, Salazar FP, et al. Primer registro de trauma en Chile. Análisis de 2 años en un hospital público. Rev. cir. [Internet]. Feb 2021 [citado 12 Jun 2023];73(1):59-65. Disponible en: https://www.scielo.cl/pdf/revistacirugia/v73n1/2452-4549-revistacirugia-73-01-0059.pdf
Labrada-Despaigne A, Bárcenas-Castro MC, Rodríguez-Acosta G. Déficit de base, lactato e índice de shock como predictores de mortalidad en lesionados múltiples. Rev Cubana Cir [Internet]. Mar 2022 [citado 12 Jun 2023];61(1):e1277. Disponible en: http://scielo.sld.cu/pdf/cir/v61n1/1561-2945-cir-61-01-e1277.pdf
Yépez-Rodríguez LB, Armijos-Dutan AA, Moreno-Villa MC. Factores de riesgo asociados a mortalidad en adultos que hayan sufrido trauma de abdomen cerrado y que hayan sido tratados quirúrgicamente. EJOM [Internet]. 2020 [citado 12 Jun 2023];3(1):1-11. Disponible en: https://www.revistafecim.org/index.php/tejom/article/download/51/44
Maegele M, Lefering R, Yucel N, Tjardes T, Rixen D, Paffrath T, et al. Early coagulopathy in multiple injury: An analysis from the German Trauma Registry on 8724 patients. Injury [Internet]. Mar 2007 [citado 12 Jun 2023];38(3):298-304. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0020138306006139
Del Valle AM, Contador C. Manejo del trauma pre-hospitalario. Qué hacer. Rev. cir. [Internet]. Jun 2023 [citado 12 Jun 2023];75(3):208-13. Disponible en: https://www.scielo.cl/pdf/revistacirugia/v75n3/2452-4549-revistacirugia-75-03-0208.pdf
Estrada-Berrio Y, Barco-Sánchez A, Ballén-Ramírez S, Salazar-Bartolo JL, Ocampo-Rincón JJ. Hipotensión permisiva en trauma. Revista médica Risaralda [Internet]. Jun 2021 [citado 12 Jun 2023];27(1):64-9. Disponible en: http://www.scielo.org.co/pdf/rmri/v27n1/0122-0667-rmri-27-01-64.pdf
Morales C, Ascuntar J, Londoño JM, Niño CD, León JP, Bernal E, et al. La depuración de lactato: marcador pronóstico de mortalidad en pacientes traumatizados. Rev. colomb. anestesiol. [Internet]. Mar 2019 [citado 12 Jun 2023];47(1):41-8. Disponible en: http://www.scielo.org.co/pdf/rca/v47n1/es_0120-3347-rca-47-01-41.pdf
Martínez-González V, Mendoza-Rodríguez M, López-González A, Cortés Munguía JA, Mendoza-Portillo E. Depuración de lactato como marcador de mortalidad en paciente con trauma. Med. crít. (Col. Mex. Med. Crit.) [Internet]. Ago 2019 [citado 12 Jun 2023]:33(4):170-5. Disponible en: https://www.scielo.org.mx/pdf/mccmmc/v33n4/2448-8909-mccmmc-33-04-170.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Yuliel Varona Rodríguez, Liliam María Castillo Manresa, Adonis Cintra Dornes
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Those authors who have publications with this journal accept the following terms of the License CC Attribution-NonCommercial 4.0 International (CC BY-NC 4.0):
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes .
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
