Transfusion therapy in the care of trauma and burn patients

John R. Hess, John B. Holcomb, Steven E. Wolf, Michael W. Cripps

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

There is an acute coagulopathy of severe trauma that is driven by blood loss and dilution, hypothermia and acidosis, and consumption of coagulation factors and platelets and fibrinolysis. Correcting this coagulopathy by resuscitation with blood products has proven to reduce blood product use and save lives following severe injury. The composition of modern blood components severely limits the ways that hemostatically balanced resuscitation can be accomplished and makes resuscitation with 1:1:1 unit ratios of red cells, plasma and platelets the most appropriate treatment for severe uncontrolled hemorrhage. Following severe burns, bone marrow becomes erythropoietin hyporesponsive probably as a result of severe inflammation. Topical and regional hemorrhage control measures allow wider early resection of burned tissue and a 5-fold reduction of blood product use. This allows early control of inflammatory myelosuppression and more effective skin grafting.

Original languageEnglish (US)
Title of host publicationRossi’s Principles of Transfusion Medicine
Publisherwiley
Pages562-573
Number of pages12
ISBN (Electronic)9781119013020
ISBN (Print)9781119012993
DOIs
StatePublished - Apr 15 2016

Keywords

  • Acute coagulopathy of trauma and shock
  • Burn resuscitation protocols
  • Coagulopathy of trauma
  • Damage control resuscitation
  • Hemorrhage control resuscitation
  • Transfusion support of trauma centers

ASJC Scopus subject areas

  • Medicine(all)

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