title: [Transfusion policy in trauma involving massive blood loss].
abstract: Severe haemorrhage is a significant cause of death in trauma patients. In the case of massive blood loss a combination of coagulation defects, acidosis and hypothermia arise, which are accompanied by high morbidity and mortality rates unless properly corrected. Research in wounded military showed that a high ratio of fresh frozen plasma to packed red blood cells (FFP:PRBC) seemed to have a positive effect on survival. These studies do not provide a definition of the ideal ratio FFP:PRBC; the ratio in which a positive effect is seen varies from 1:1 to 1:3. Unnecessary FFP transfusions in trauma patients without imminent severe haemorrhage increase the risk of complications such as multi-organ failure and acute respiratory distress syndrome. Additional research is required into the accuracy of diagnosis of acute coagulation disorders.
authors.affiliation: Academisch Medisch Centrum, Afd. Chirurgie, Trauma Unit, Amsterdam, The Netherlands. t.p.saltzherr@amc.uva.nl
authors.forename: Teun Peter
authors.initials: TP
authors.lastname: Saltzherr
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Christiaans
authors.forename: C Pieter
authors.initials: CP
authors.lastname: Henny
authors.forename: Marcel M
authors.initials: MM
authors.lastname: Levi
authors.forename: J Carel
authors.initials: JC
authors.lastname: Goslings
mesh_terms: D001778:Blood Coagulation Disorders / Q000401:mortality / Q000628:therapy; D016913:Blood Component Transfusion / Q000379:methods* / Q000401:mortality*; D017707:Erythrocyte Transfusion; D006470:Hemorrhage / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D009104:Multiple Trauma / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome