Transfusion in polytraumatised patients

Background and Aim. Recent evidence indicates that surgical bleeding due to injured vessels and traumatic coagulopathy are the main reasons of uncontrolled haemorrhage in polytraumatized patients in the first 24 hours. The cornerstone of the treatment is adequate empiric early transfusion. The aim of our study was to survey the early transfusion in patients with major trauma and define the ratio of applied transfusion component in our hospital. Patients and Methods: Patients with major trauma for a one year period, admitted to the Emergency Department of the Clinical Hospital Centre, Zagreb, were enrolled in our retrospective study. The following data were collected: age, sex, mechanism of injury, initial shock index (SI), initial Glasgow Coma Score (GCS), Injury severity score (ISS), and initial hemoglobin (Hb) and prothrombin time (PT). Intra-operative transfusion and transfusion within the first 24 hours of injury, Intensive care unit (ICU) stay and clinical outcome were assessed. Results. 16 patients with major trauma were admitted. Eight patients received transfusions. Two patients received a massive transfusion. The transfusion ratio of Fresh frozen plasma (FFP) : Packed red blood cells (PRBC) : Platelets (PLT) during major trauma resuscitation was 1:1,5:1 in our study. One of the 16 patients died. Conclusion. Early and aggressive resuscitation with transfusion blood products in major trauma patients within the first 24 hours with the FFP:PRBC:PLT ratio 1:1:1 is the key for prevention of trauma induced coagulopathy and its lethal consequences. Massive transfusion protocol for major trauma patients should be implemented in everyday practice.