Evolution of Practices in a French Trauma Centre: Decrease in Blood Transfusions and Fresh Frozen Plasma to Red Blood Cell Ratios - Université Claude Bernard Lyon 1 Accéder directement au contenu
Article Dans Une Revue Turkish Journal of Anaesthesiology and Reanimation Année : 2021

Evolution of Practices in a French Trauma Centre: Decrease in Blood Transfusions and Fresh Frozen Plasma to Red Blood Cell Ratios

Cyril Pernod
  • Fonction : Auteur
Guillaume Marcotte
  • Fonction : Auteur
Bernard Floccard
  • Fonction : Auteur
Thibaut Girardot
  • Fonction : Auteur
Clement Claustre
  • Fonction : Auteur
Carlos El Khoury
  • Fonction : Auteur
Thomas Rimmele
  • Fonction : Auteur

Résumé

Objective: The aim of this study was to describe the evolution of transfusion practices following the introduction of tranexamic acid (TXA) and ROTEMVR in a trauma resuscitation unit (TRU) from a French teaching hospital (FTH). Methods: This is a single-centre, retrospective study at a TRU from a FTH. All trauma patients aged 18 years or more and transfused with at least 4 red blood cells (RBCs) within 24 hours after trauma, from 2011 to 2016, were included. The primary objective was to analyse transfusion practices over this time period. The secondary objectives aimed at assessing differences between populations according to the fresh frozen plasma (FFP):RBC ratio applied. Results: A total of 122 patients were included. There was a significant decrease in the proportion of patients requiring at least 4 RBCs 24 hours after trauma (9% vs. 3%, P trend < .0001) as well as a decrease in the proportion of patients with a high FFP:RBC ratio (86% vs. 62% at 6 hours, P trend = .0056 and 86% vs. 56% at 24 hours, P trend = .0047). After 2013, fibrinogen was administered to more than 70% of patients and TXA to 100% of them. The observed mortality was lower than the predicted one, irrespective of FFP:RBC ratio. Conclusion: An important evolution of practices occurred including a decrease in the proportion of transfusions and use of high FFP:RBC ratios. The origin of these changes is multifactorial, likely including the systematic use of TXA and optimisation of the ROTEM protocol for fibrinogen administration.

Dates et versions

hal-03559168 , version 1 (06-02-2022)

Identifiants

Citer

Cyril Pernod, Laurie Fraticelli, Guillaume Marcotte, Bernard Floccard, Thibaut Girardot, et al.. Evolution of Practices in a French Trauma Centre: Decrease in Blood Transfusions and Fresh Frozen Plasma to Red Blood Cell Ratios. Turkish Journal of Anaesthesiology and Reanimation, 2021, 49 (5), pp.365-372. ⟨10.5152/TJAR.2021.1229⟩. ⟨hal-03559168⟩

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