Abstract
PURPOSE OF REVIEW: Blood transfusion is ubiquitous in major burn injury. The present article describes recent research findings directly impacting blood transfusion strategies in major burn injury both in the operating room and the ICU. RECENT FINDINGS: Transfusion strategies have been the focus of recent burn investigations. First, a randomized prospective trial encompassing both the ICU and operating room reported that a restrictive red blood cell transfusion threshold (7 g/dl) had equivalent outcomes to a traditional threshold (10 g/dl) for burns more than 20% in terms of mortality, infection, length of stay, duration of mechanical ventilation, and wound healing despite receiving significantly fewer transfusions. The second burn transfusion advance addresses coagulation. Although burn patients initially have elevated fibrinogen, thrombocytopenia and other coagulation disorders develop during excision. Blood product repletion should be based on measurements such as thromboelastography in addition to traditional tests. Finally, a recent randomized trial suggests that fresh-frozen plasma and platelets during burn excision more than 20% may decrease transfusion requirements. SUMMARY: A restrictive transfusion practice during burn excision and grafting is well tolerated and effective in reducing the number of transfusions without increasing complications. Repletion of coagulation products should focus on measured deficits of platelets, fibrinogen, and factors.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 247-251 |
| Number of pages | 5 |
| Journal | Current opinion in anaesthesiology |
| Volume | 32 |
| Issue number | 2 |
| DOIs | |
| State | Published - Apr 1 2019 |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Burn injury and blood transfusion. / Palmieri, Tina L.
In: Current opinion in anaesthesiology, Vol. 32, No. 2, 01.04.2019, p. 247-251.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Burn injury and blood transfusion
AU - Palmieri, Tina L
PY - 2019/4/1
Y1 - 2019/4/1
N2 - PURPOSE OF REVIEW: Blood transfusion is ubiquitous in major burn injury. The present article describes recent research findings directly impacting blood transfusion strategies in major burn injury both in the operating room and the ICU. RECENT FINDINGS: Transfusion strategies have been the focus of recent burn investigations. First, a randomized prospective trial encompassing both the ICU and operating room reported that a restrictive red blood cell transfusion threshold (7 g/dl) had equivalent outcomes to a traditional threshold (10 g/dl) for burns more than 20% in terms of mortality, infection, length of stay, duration of mechanical ventilation, and wound healing despite receiving significantly fewer transfusions. The second burn transfusion advance addresses coagulation. Although burn patients initially have elevated fibrinogen, thrombocytopenia and other coagulation disorders develop during excision. Blood product repletion should be based on measurements such as thromboelastography in addition to traditional tests. Finally, a recent randomized trial suggests that fresh-frozen plasma and platelets during burn excision more than 20% may decrease transfusion requirements. SUMMARY: A restrictive transfusion practice during burn excision and grafting is well tolerated and effective in reducing the number of transfusions without increasing complications. Repletion of coagulation products should focus on measured deficits of platelets, fibrinogen, and factors.
AB - PURPOSE OF REVIEW: Blood transfusion is ubiquitous in major burn injury. The present article describes recent research findings directly impacting blood transfusion strategies in major burn injury both in the operating room and the ICU. RECENT FINDINGS: Transfusion strategies have been the focus of recent burn investigations. First, a randomized prospective trial encompassing both the ICU and operating room reported that a restrictive red blood cell transfusion threshold (7 g/dl) had equivalent outcomes to a traditional threshold (10 g/dl) for burns more than 20% in terms of mortality, infection, length of stay, duration of mechanical ventilation, and wound healing despite receiving significantly fewer transfusions. The second burn transfusion advance addresses coagulation. Although burn patients initially have elevated fibrinogen, thrombocytopenia and other coagulation disorders develop during excision. Blood product repletion should be based on measurements such as thromboelastography in addition to traditional tests. Finally, a recent randomized trial suggests that fresh-frozen plasma and platelets during burn excision more than 20% may decrease transfusion requirements. SUMMARY: A restrictive transfusion practice during burn excision and grafting is well tolerated and effective in reducing the number of transfusions without increasing complications. Repletion of coagulation products should focus on measured deficits of platelets, fibrinogen, and factors.
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UR - http://www.scopus.com/inward/citedby.url?scp=85062409904&partnerID=8YFLogxK
U2 - 10.1097/ACO.0000000000000701
DO - 10.1097/ACO.0000000000000701
M3 - Article
C2 - 30817402
AN - SCOPUS:85062409904
VL - 32
SP - 247
EP - 251
JO - Current Opinion in Anaesthesiology
JF - Current Opinion in Anaesthesiology
SN - 0952-7907
IS - 2
ER -