Blood product transfusion: Does location make a difference?

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Early blood product administration during acute blood loss may improve outcomes, yet blood product transfusion for anemia of critical illness has been associated with increased mortality. After major burn injury, patients have two sources of anemia: massive acute blood loss during excision and insidious losses in the intensive care unit (ICU). The purpose of this study was to assess the relationship between the administration of fresh frozen plasma (FFP), platelets, and cryoprecipitate and outcomes in children with major burn injury. This was a retrospective review of children admitted with >20% TBSA burn from 2006 to 2009. Parameters measured included demographics, injury characteristics, operations, blood product transfusions, and outcomes. A total of 143 children received a mean of 3342 ± 283 ml blood. Nonsurvivors had larger burns (62.1 ± 4.6% vs 41.0 ± 1.5% TBSA, P < .001) and received similar amounts of packed red blood cells (PRBCs) during hospitalization (12.8 ± 2.4 units vs 10.9 ± 1.0 units, P = .5) than survivors. Nonsurvivors received more total units of FFP during hospitalization than survivors (8.0 ± 1.7 units vs 3.1 ± 0.4 units, P < .0001) because of the FFP units transfused in the ICU (5.5 ± 1.2 units vs 1.1 ± 0.2 units, P < .0001). The overall FFP:PRBC transfusion ratio in survivors was 1:4, whereas mean FFP:PRBC volume ratio in nonsurvivors was 3:4 (P < .0001). Nonsurvivors received more platelets (3.4 ± 1.0 units vs 0.50 ± 0.1 units, P < .001) and cryoprecipitate (1.9 ± 0.9 units vs 0.3 ± 0.1 units, P < .001) than survivors, both in the operating room and in the ICU. Blood product use in children with severe burns is associated with increased mortality. Appropriate use of blood products may need to be different in the operating room (massive acute hemorrhage) vs the ICU (ongoing red cell senescence).

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalJournal of Burn Care and Research
Volume32
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Blood Transfusion
Intensive Care Units
Survivors
Operating Rooms
Burns
Anemia
Wounds and Injuries
Hospitalization
Blood Platelets
Erythrocytes
Erythrocyte Transfusion
Mortality
Cell Aging
Blood Volume
Hematocrit
Critical Illness
Demography
Hemorrhage

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

Blood product transfusion : Does location make a difference? / Palmieri, Tina L; Sen, Soman; Falwell, Katrina; Greenhalgh, David G.

In: Journal of Burn Care and Research, Vol. 32, No. 1, 01.2011, p. 61-65.

Research output: Contribution to journalArticle

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abstract = "Early blood product administration during acute blood loss may improve outcomes, yet blood product transfusion for anemia of critical illness has been associated with increased mortality. After major burn injury, patients have two sources of anemia: massive acute blood loss during excision and insidious losses in the intensive care unit (ICU). The purpose of this study was to assess the relationship between the administration of fresh frozen plasma (FFP), platelets, and cryoprecipitate and outcomes in children with major burn injury. This was a retrospective review of children admitted with >20{\%} TBSA burn from 2006 to 2009. Parameters measured included demographics, injury characteristics, operations, blood product transfusions, and outcomes. A total of 143 children received a mean of 3342 ± 283 ml blood. Nonsurvivors had larger burns (62.1 ± 4.6{\%} vs 41.0 ± 1.5{\%} TBSA, P < .001) and received similar amounts of packed red blood cells (PRBCs) during hospitalization (12.8 ± 2.4 units vs 10.9 ± 1.0 units, P = .5) than survivors. Nonsurvivors received more total units of FFP during hospitalization than survivors (8.0 ± 1.7 units vs 3.1 ± 0.4 units, P < .0001) because of the FFP units transfused in the ICU (5.5 ± 1.2 units vs 1.1 ± 0.2 units, P < .0001). The overall FFP:PRBC transfusion ratio in survivors was 1:4, whereas mean FFP:PRBC volume ratio in nonsurvivors was 3:4 (P < .0001). Nonsurvivors received more platelets (3.4 ± 1.0 units vs 0.50 ± 0.1 units, P < .001) and cryoprecipitate (1.9 ± 0.9 units vs 0.3 ± 0.1 units, P < .001) than survivors, both in the operating room and in the ICU. Blood product use in children with severe burns is associated with increased mortality. Appropriate use of blood products may need to be different in the operating room (massive acute hemorrhage) vs the ICU (ongoing red cell senescence).",
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