Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Reappraising the concept of massive transfusion in trauma. | Stanworth et al. Critical Care 2010 14 R239 http content 14 6 R239 KS CRITICAL CARE RESEARCH Open Access Reappraising the concept of massive transfusion in trauma Qimritì I Cfoi A rt t ri n 1Ti mrnfHx D K ir trric2 fCI-rorHor3 I f 2rol r r iclif ir ic4 í Ì3r K isỉonolo5 í i ii k iCil I I ihon6 Jimun J Sidnvvoiui limouiy P Moiiis Cinisune Gddidei J Cdiel Goslings Mdic Mdegele Miicnell J cunen 7 7 8 9 10 Thomas c Konig Ross A Davenport Jean-Francois Pittet Pai I Johansson Shubhd Allaid Tony Johnson Kdiim Biohi7 Abstract Introduction The massive-transfusion concept was introduced to recognize the dilutional complications resulting from laige volumes of packed ied blood cells PRBCs . Definitions of massive transfusion vaiy and lack supporting clinical evidence. Damage-control resuscitation regimens of modem trauma caie die taigeted to the eai ly coiiection of acute traumatic coagulopathy. The aim of this study was to identify a clinically relevant definition of tiauma massive transfusion based on clinical outcomes. We also examined whethei the concept was useful in that eaily piediction of massive transfusion requirements could allow early activation of blood bank protocols. Methods Datasets on tiauma admissions ovei a 1 oi 2-yeai peiiod weie obtained fiom the tiauma registries of five laige tiauma research netwoiks. A fractional polynomial was used to model the transfusion-associated probability of death. A logistic regression model foi the piediction of massive transfusion defined as 10 oi moie units of ied cell transfusions was developed. Results In total 5 693 patient iecoids weie available foi analysis. Mortality increased as transfusion requirements increased but the model indicated no threshold effect. Mortality was 9 in patients who received none to five PRBC units 22 in patients receiving six to nine PRBC units and 42 in patients receiving 10 oi moie units. A logistic model foi piediction of massive transfusion was developed and validated at .
