Fresh Frozen Plasma
Abstract
For years, much has been said and written concerning transfusion practices in the massively bleeding patient. It makes intuitive sense to transfuse whole blood into the massively bleeding patient since that is exactly what the patient is losing. However, since whole blood is not a product that is available for common hospital use, crystalloids and packed cells are commonly infused to treat the massively bleeding. Infusing a crystalloid solution (normal saline or lactated Ringer's solution) or stored packed red blood cells without clotting factors into a hemorrhaging patient will dilute the clotting factors and can actually make the patient more coagulopathic. Coagulopathy clearly correlates with mortality in severely injured damage control patients. Combat injured casualties represent a unique subset of these patients, often with massive tissue injury. While administering packed red blood cells replaces oxygen carrying capacity, it is deficient in coagulation factors. Whole blood administration accomplishes both red cell and plasma replacement, but it is both labor and time intensive. Aggressively replacing the lost clotting factors approaching a 1:1 ratio of FFP to pRBCs should be a goal in all abbreviated damage control operations and intensive care unit resuscitation of all severely injured patients undergoing a massive blood transfusion (>10 units of pRBCs in 24 hours) in the combat zone. This is accomplished by assuring FFP is readily available and pushing FFP far forward to surgical facilities on the battlefield. There have been many recent discussions on the benefits of FFP in combat wounded; this paper provides some basic information on the subject.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 01, 2009
- Accession Number
- ADA519234
Entities
People
- Brian Eastridge
- Clayton D. Simon
- J. S. Perkins
- Lorne H Blackbourne
- Paul Barras