Impact of Policy Change on US Army Combat Transfusion Practices
Abstract
Background: Clinical practice guidelines (CPGs) are used to keep providers up-to-date with the most recent literature and to guide in decision making. Adherence is typically improved although many have a muted impact. In March 2006, the US Army issued a damage control resuscitation CPG, encouraging 1:1 plasma:red blood cell (RBC) transfusions and limiting crystalloid use. The objective of this study was to determine whether the CPG was associated with a change in the transfusion practices in combat- wounded patients. Methods: All US service members injured in Operation Iraqi Freedom/ Operation Enduring Freedom who received massive transfusions (MTs; 10 RBC in 24 hours) were queried from the US Army Institute of Surgical Research transfusion database. Whole blood, when used, was counted as 1 unit of RBC, fresh frozen plasma (FFP), and platelet. Subjects were divided into pre- and post-CPG cohorts. Primary outcomes were ratios of FFP:RBC and crystalloid use.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 01, 2010
- Accession Number
- ADA630246
Entities
People
- Brian J. Eastridge
- Charles E Wade
- Christopher E. White
- James E. Mace
- John W. Simmons
- Lorne H Blackbourne
Organizations
- United States Army Institute of Surgical Research