Combat Trauma Hemorrhage Treatment, Early Use of Whole Blood in Pre-hospital Treatment (Point of Injury)
Abstract
Hemorrhage is the leading cause of preventable death in trauma. Contemporary treatment for damage control resuscitation (DCR) consists of early hemorrhage control, permissive hypotension, asanguineous fluid minimization and fixed ratio blood product transfusion. Widespread interest in utilizing whole blood in pre-hospital care has increased in both civilian and military medicine. While movement towards the use of pre-hospital blood product administration, ractionated component therapy or whole blood, is accelerating with evidence of survival benefits, the physiologic mechanism(s) underlying the benefits of pre-hospital blood administration remains to be fully elucidated. Perhaps more importantly, the logistical challenge of early blood product administration in the pre-hospital environment (e.g. product cost, storage and transport) is a significant problem. Improvements in survival of traumatic hemorrhage are correlated with increasing levels of fibrinogen. Additionally, increased fibrinogen use has been shown to improve mortality in combat casualties. Thus, fibrinogen is an essential component of the coagulation system and low fibrinogen levels are associated with bleeding, transfusion and poor outcomes. We postulated that the utilization of Fibrinogen Supplemented Albumin Resuscitation as an initial fluid/volume resuscitation in the treatment of traumatic hemorrhage will lead to the beneficial outcomes using RiaSTAP and albumin. Our primary scientific aim was to determine the specifics of reconstituting the solution and determine its stability.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 09, 2022
- Accession Number
- AD1181486
Entities
People
- Carolyne Falank
- Forest Sheppard
Organizations
- Maine Medical Center