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Incompatible type A plasma transfusion in patients requiring massive transfusion protocol: Outcomes of an Eastern Association for the Surgery of Trauma multicenter study
- Source :
- The journal of trauma and acute care surgery. 83(1)
- Publication Year :
- 2017
-
Abstract
- With a relative shortage of type AB plasma, many centers have converted to type A plasma for resuscitation of patients whose blood type is unknown. The goal of this study is to determine outcomes for trauma patients who received incompatible plasma transfusions as part of a massive transfusion protocol (MTP).As part of an Eastern Association for the Surgery of Trauma multi-institutional trial, registry and blood bank data were collected from eight trauma centers for trauma patients (age, ≥ 15 years) receiving emergency release plasma transfusions as part of MTPs from January 2012 to August 2016. Incompatible type A plasma was defined as transfusion to patient blood type B or type AB.Of the 1,536 patients identified, 92% received compatible plasma transfusions and 8% received incompatible type A plasma. Patient characteristics were similar except for greater penetrating injuries (48% vs 36%; p = 0.01) in the incompatible group. In the incompatible group, patients were transfused more plasma units at 4 hours (median, 9 vs. 5; p0.001) and overall for stay (11 vs. 9; p = 0.03). No hemolytic transfusion reactions were reported. Two transfusion-related acute lung injury events were reported in the compatible group. Between incompatible and compatible groups, there was no difference in the rates of acute respiratory distress syndrome (6% vs. 8%; p = 0.589), thromboembolic events (9% vs. 7%; p = 0.464), sepsis (6% vs. 8%; p = 0.589), or acute renal failure (8% vs. 8%, p = 0.860). Mortality at 6 (17% vs. 15%, p = 0.775) and 24 hours (25% vs. 23%, p = 0.544) and at 28 days or discharge (38% vs. 35%, p = 0.486) were similar between groups. Multivariate regression demonstrated that Injury Severity Score, older age and more red blood cell transfusion at 4 hours were independently associated with death at 28 days or discharge; Injury Severity Score and more red blood cell transfusion at 4 hours were predictors for morbidity. Incompatible transfusion was not an independent determinant of mortality or morbidity.Transfusion of type A plasma to patients with blood groups B and AB as part of a MTP does not appear to be associated with significant increases in morbidity or mortality.Therapeutic study, level IV.
- Subjects :
- Adult
Male
medicine.medical_specialty
Resuscitation
Adolescent
Blood Component Transfusion
Hemorrhage
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
03 medical and health sciences
Plasma
0302 clinical medicine
Injury Severity Score
Trauma Centers
Risk Factors
medicine
Humans
In patient
Registries
Intensive care medicine
Aged
Retrospective Studies
Blood type
Aged, 80 and over
business.industry
Plasma transfusions
030208 emergency & critical care medicine
Retrospective cohort study
Middle Aged
Massive transfusion
United States
Surgery
Treatment Outcome
Multicenter study
Blood Group Incompatibility
Wounds and Injuries
Female
business
Subjects
Details
- ISSN :
- 21630763
- Volume :
- 83
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The journal of trauma and acute care surgery
- Accession number :
- edsair.doi.dedup.....67c0358c58a5df7b4fefe2d67d5ba59f