The use of blood in resuscitation of the trauma patient.
The ability to transfuse blood (a form of tissue transplantation) with relatively few immediate and long-term complications has led to increased survival in victims of injury who require massive amounts of blood. The primary deficit in hypovolemic shock secondary to trauma is in oxygen transport to the hypoperfused tissues; therefore, blood transfusion has an essential role in therapy during resuscitation and definitive treatment. The major immediate complications to be avoided are hypothermia and acidosis, which are the main causes of the coagulopathy associated with massive transfusion. The most worrisome long-term complication is the transmission of disease, of which hepatitis C is the most frequent. With improved screening techniques and heightened donor awareness, the risk of disease transmission is less than 2%. Until synthetic oxygen-carrying solutions are available, the transfusion of red blood cells, when appropriately indicated, will remain an important component in the resuscitation of the trauma patient.
Hamilton
S M
SM
Department of Surgery, University of Alberta, Edmonton.
D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission; D001778:Blood Coagulation Disorders / Q000209:etiology; D001803:Blood Transfusion; D004630:Emergencies; D006801:Humans; D007035:Hypothermia / Q000209:etiology; D010100:Oxygen / Q000378:metabolism; D012151:Resuscitation / Q000379:methods*; D065227:Transfusion Reaction; D014947:Wounds and Injuries / Q000378:metabolism / Q000628:therapy*
D010100:Oxygen