Critiques Editing

Transfusion Therapy in Hemorrhagic Shock

Timothy Moore

Purpose

The purpose of this article is to identify the most appropriate and effective resuscitation strategies on reestablishing tissue perfusion by administration of whole blood or blood components as well as the most appropriate protocol to prevent coagulopathy.

Background

The onset of coagulopathy happens quickly in trauma patients, increasing the chances of mortality due to ACoTS (acute coagulopathy of traumatic shock). Early execution of damage control resuscitative (DCR) procedures is essential. Current proof does not describe the ideal ratio but data suggest it should be a high ratio of plasma to packed red blood cells.

Methodology

The study involves a lengthy data analysis and data interpretation. We took a small sample for the purpose of clear results and transparency in research. The diverse patients were a part of our data collection and data interpretation. It was retrospective in the sense that the patients were aligned with their respective diseases. The retrospective analysis got the primary importance in data collection since we are talking about blood transfusion.

Results

The study results suggested utilizing an appropriate 3:2 ratio of the red cells as compared plasma and platelets that are of the utmost utilization. Several large retrospective studies showed higher survival rates when ratios of 1:1 were used, no randomized control studies compare current damage control resuscitation to more traditional resuscitation methods.

Conclusion

Although only about 5% of trauma patients actually require massive transfusion, the practice of transfusion therapy has a large role to play in reducing the occurrence of trauma in the future. Implementation of a uniform protocol with early activation criteria, delivery of the required products in pre-specified ratios, and rigorous implementation of practice and quality standards have been identified as crucial factors necessary for reducing mortality. The scarcity of whole blood and blood components necessitate rigorous standards and protocols to be implemented in order to facilitate optimal utilization.

Comment

Hemorrhage and reduced tissue perfusion are the leading causes of death following acute trauma, yet ideal resuscitative protocols that need to be established and standardized. With this motive in mind, the authors have reviewed the current practices and tried to suggest the most appropriate resuscitative strategies, focusing especially on the various protocols being followed and the ratios in which cellular components, plasma, and coagulation factors needed to be administered. The significance for arranging specialized controlled studies is significantly minimized and the retrospective considerations must be taken into context. The retrospective studies played a huge role in the interpretation of results as the retrospective elements are of paramount importance in our retrospective study. Massive transfusion at the earliest stage possible in exsanguinations patients is likely to improve outcomes. (Nunez, C. T.,& Cotton, B. A. 2009). Likewise, early institution of damage control resuscitation is preferred. The studies reviewed in this article helped in building knowledge towards the development of a common DCR protocol. Institutions have been without true massive transfusion (MT) protocols for hemorrhagic situations, partly because there have been no reliable and valid studies to support a common protocol.

The study involved a retrospective analysis of the administration ...