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Impact of Improved Combat Casualty Care on Combat Wounded Undergoing Exploratory Laparotomy and Massive Transfusion.

机译：改进作战伤员护理对剖腹探查和大规模输血伤员的影响。

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Background: Studies have shown decreased mortality after improvements in combat casualty care, including increased fresh frozen plasma (FFP):red blood cell (RBC) ratios. The objective was to evaluate the evolution and impact of improved combat casualty care at different time periods of combat operations. Methods: A retrospective review was performed at one combat support hospital in Iraq of patients requiring both massive transfusion (>/= 10 units RBC in 24 hours) and exploratory laparotomy. Patients were divided into two cohorts based on year wounded: C1 between December 2003 and June 2004, and C2 between September 2007 and May 2008. Admission data, amount of blood products and fluid transfused, and 48 hour mortality were compared. Statistical significance was set at p < 0.05. Results: There was decreased mortality in C2 (47% vs. 20%). Patients arrived warmer with higher hemoglobin. They were transfused more RBC and FFP in the emergency department (5 units +/- 3 units vs. 2 units +/- 2 units; 3 units 2 units vs. 0 units +/- 1 units, respectively) and received less crystalloid in operating room (3.3 L +/- 2.2 L vs. 8.5 L +/- 4.9 L). The FFP:RBC ratio was also closer to 1:1 in C2 (0.775 +/- 0.32 vs. 0.511 +/- 0.21). Conclusions: The combination of improved prehospital care, trauma systems approach, performance improvement projects, and improved transfusion or resuscitation practices have led to a 50% decrease in mortality for this critically injured population. We are now transfusing blood products in a ratio more consistent with 1 FFP to 1 RBC. Simultaneously, crystalloid use has decreased by 61%, all of which is consistent with hemostatic resuscitation principles.

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Simmons, J. W.; White, C. E.; Eastridge, B. J.; Holcomb, J. B.; Perkins, J. G.; Mace, J. E.; Blackbourne, L. H.;
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年度 2011
页码 1-6
总页数 6
原文格式 PDF
正文语种 eng
中图分类工业技术;
关键词
Blood cells; Blood plasma; Blood transfusion; Hemorrhage; Military medicine; Mortality rate; Ratios; Resuscitation; Trauma; Damage control resuscitation; Massive transfusions; Exploratory laparotomies; Ffp(fresh frozen plasma); Rbc(red blood cells); Ffp:rbc ratios;

机译：血细胞;血浆;输血;出血;军事医学;死亡率;比率;复苏;创伤;损伤控制复苏;大量输血;剖腹探查; Ffp（新鲜冰冻血浆）; Rbc（红细胞）; Ffp：rbc比;

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1. Impact of improved combat casualty care on combat wounded undergoing exploratory laparotomy and massive transfusion. [J] . Simmons JW, White CE, Eastridge BJ, The Journal of trauma . 2011,第1Suppla期

机译：改进的战斗伤亡护理对进行探索性剖腹手术和大量输血的战斗伤的影响。
2. Impact of extremity amputation on combat wounded undergoing exploratory laparotomy. [J] . White CE, Simmons JW, Holcomb JB, The Journal of trauma . 2009,第4Suppla期

机译：截肢对探索性剖腹手术中战斗伤的影响。
3. Died of wounds on the battlefield: causation and implications for improving combat casualty care. [J] . Eastridge BJ, Hardin M, Cantrell J, The Journal of trauma . 2011,第1Suppla期

机译：战场上死伤重伤：改善战斗伤亡护理的因果关系和意义。
4. Framework for Guiding Artificial Intelligence Research in Combat Casualty Care [C] . Kenneth H. Wong SPIE Medical Imaging Conference . 2019

机译：指导人工智能研究的框架在作战伤亡小心
5. An Exploratory Study on Unit Performance While Serving in a Combat Zone [D] . Peters, Tammy Marie. 2019

机译：在战斗区供应时单位性能的探索性研究
6. Coagulation disorders in combat casualties. I. Acute changes after wounding. II. Effects of massive transfusion. 3. Post-resuscitative changes. [O] . R L Simmons, J A Collins, C A Heisterkamp, 1969

机译：战斗伤亡中的凝血障碍。 I.受伤后的急性变化。二。大量输血的影响。 3.复苏后的变化。
7. Bi-Layer Wound Dressing System for Combat Casualty Care [O] . Lucie Martineau, Pang N. Shek 2016

机译：用于战斗伤员护理的双层伤口敷料系统

Impact of Improved Combat Casualty Care on Combat Wounded Undergoing Exploratory Laparotomy and Massive Transfusion.

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