Platelet transfusion increases risk for acute respiratory distress syndrome in non-massively transfused blunt trauma patients.

Published

Journal Article

PURPOSE: While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients. METHODS: The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified. Patients were divided into quartiles depending on platelet volume they were transfused in the first 48 h. Outcomes of interest included mortality; ventilator, Intensive Care Unit (ICU) and hospital length of stay (LOS); infectious and non-infectious complications. Multivariable regression models were fitted for these outcomes, controlling for age, pre-existing comorbidities, injury severity, acute physiologic derangement, neurologic injury burden, and other fluid and blood product resuscitation. RESULTS: There was no difference in mortality, LOS, or the incidence of multi-organ failure and infectious complications. However, patients receiving ≥ 250 mL of platelets were more likely to develop acute respiratory distress syndrome (ARDS) compared to those who received < 250 mL [odds ratio 1.91 (95% CI 1.10-3.33, p = 0.022)]. CONCLUSIONS: Pre-emptive platelet transfusion should be avoided in non-massively transfused blunt injury victims in the absence of true or functional thrombocytopenia, as it increases risk for ARDS with no survival benefit.

Full Text

Duke Authors

Cited Authors

  • Kasotakis, G; Starr, N; Nelson, E; Sarkar, B; Burke, PA; Remick, DG; Tompkins, RG; Inflammation and Host Response to Injury Investigators,

Published Date

  • August 2019

Published In

Volume / Issue

  • 45 / 4

Start / End Page

  • 671 - 679

PubMed ID

  • 29627883

Pubmed Central ID

  • 29627883

Electronic International Standard Serial Number (EISSN)

  • 1863-9941

Digital Object Identifier (DOI)

  • 10.1007/s00068-018-0953-4

Language

  • eng

Conference Location

  • Germany