Efficacy of a high FFP: PRBC transfusion ratio on the survival of severely injured patients: A retrospective study in a single tertiary emergency center in Japan

Daisuke Kudo, Junichi Sasaki, Satoshi Akaishi, Satoshi Yamanouchi, Tomoaki Koakutsu, Tomoyuki Endo, Takeaki Sato, Ryosuke Nomura, Hironao Yuzawa, Michio Kobayashi, Yotaro Shinozawa, Shigeki Kushimoto

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: Recent studies have shown increased survival benefits when a high fresh frozen plasma (FFP) to packed red blood cell (PRBC) ratio is used during trauma resuscitation. However, some reports have raised questions about the effect of higher FFP:PRBC transfusion ratios. The aim of this study was to examine the efficacy of high FFP:PRBC ratios in injured patients with regard to survival and morbidity in a single tertiary emergency center in Japan. Methods: This study examined severe trauma patients who received 10 or more PRBC units during the first 24 h of admission. We examined the relationship between the FFP:PRBC ratios during the first 6 h and the patient outcome. Results: The severity was similar among all groups. The mortality rate was 44.4 % in the high (>1:1.5), 16.7 % in the middle (1:1.5-1:2) and 33.3 % in the low (<1:2) F:P ratio groups. Only one patient in the high group developed sepsis, and none of the patients developed ARDS. Conclusions: The current results indicate that the FFP:PRBC ratios during the first 6 h after admission might not affect the mortality or morbidity. However, differences between trauma care systems in Japan and other countries, along with other study limitations, necessitate that a subsequent prospective multicenter study be undertaken before any definitive conclusions can be made.

Original languageEnglish
Pages (from-to)653-661
Number of pages9
JournalSurgery Today
Volume44
Issue number4
DOIs
Publication statusPublished - 2014

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Erythrocyte Transfusion
Japan
Emergencies
Retrospective Studies
Erythrocytes
Survival
Wounds and Injuries
Morbidity
Mortality
Resuscitation
Multicenter Studies
Sepsis
Prospective Studies

Keywords

  • Fresh frozen plasma
  • Hemostatic resuscitation
  • Massive transfusion
  • Postinjury
  • Transfusion ratio

ASJC Scopus subject areas

  • Surgery

Cite this

Efficacy of a high FFP : PRBC transfusion ratio on the survival of severely injured patients: A retrospective study in a single tertiary emergency center in Japan. / Kudo, Daisuke; Sasaki, Junichi; Akaishi, Satoshi; Yamanouchi, Satoshi; Koakutsu, Tomoaki; Endo, Tomoyuki; Sato, Takeaki; Nomura, Ryosuke; Yuzawa, Hironao; Kobayashi, Michio; Shinozawa, Yotaro; Kushimoto, Shigeki.

In: Surgery Today, Vol. 44, No. 4, 2014, p. 653-661.

Research output: Contribution to journalArticle

Kudo, D, Sasaki, J, Akaishi, S, Yamanouchi, S, Koakutsu, T, Endo, T, Sato, T, Nomura, R, Yuzawa, H, Kobayashi, M, Shinozawa, Y & Kushimoto, S 2014, 'Efficacy of a high FFP: PRBC transfusion ratio on the survival of severely injured patients: A retrospective study in a single tertiary emergency center in Japan', Surgery Today, vol. 44, no. 4, pp. 653-661. https://doi.org/10.1007/s00595-013-0518-4
Kudo, Daisuke ; Sasaki, Junichi ; Akaishi, Satoshi ; Yamanouchi, Satoshi ; Koakutsu, Tomoaki ; Endo, Tomoyuki ; Sato, Takeaki ; Nomura, Ryosuke ; Yuzawa, Hironao ; Kobayashi, Michio ; Shinozawa, Yotaro ; Kushimoto, Shigeki. / Efficacy of a high FFP : PRBC transfusion ratio on the survival of severely injured patients: A retrospective study in a single tertiary emergency center in Japan. In: Surgery Today. 2014 ; Vol. 44, No. 4. pp. 653-661.
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AU - Sasaki, Junichi

AU - Akaishi, Satoshi

AU - Yamanouchi, Satoshi

AU - Koakutsu, Tomoaki

AU - Endo, Tomoyuki

AU - Sato, Takeaki

AU - Nomura, Ryosuke

AU - Yuzawa, Hironao

AU - Kobayashi, Michio

AU - Shinozawa, Yotaro

AU - Kushimoto, Shigeki

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AB - Purpose: Recent studies have shown increased survival benefits when a high fresh frozen plasma (FFP) to packed red blood cell (PRBC) ratio is used during trauma resuscitation. However, some reports have raised questions about the effect of higher FFP:PRBC transfusion ratios. The aim of this study was to examine the efficacy of high FFP:PRBC ratios in injured patients with regard to survival and morbidity in a single tertiary emergency center in Japan. Methods: This study examined severe trauma patients who received 10 or more PRBC units during the first 24 h of admission. We examined the relationship between the FFP:PRBC ratios during the first 6 h and the patient outcome. Results: The severity was similar among all groups. The mortality rate was 44.4 % in the high (>1:1.5), 16.7 % in the middle (1:1.5-1:2) and 33.3 % in the low (<1:2) F:P ratio groups. Only one patient in the high group developed sepsis, and none of the patients developed ARDS. Conclusions: The current results indicate that the FFP:PRBC ratios during the first 6 h after admission might not affect the mortality or morbidity. However, differences between trauma care systems in Japan and other countries, along with other study limitations, necessitate that a subsequent prospective multicenter study be undertaken before any definitive conclusions can be made.

KW - Fresh frozen plasma

KW - Hemostatic resuscitation

KW - Massive transfusion

KW - Postinjury

KW - Transfusion ratio

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