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Citation
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Martinez T, François A, Pouget T, Carli P, Lapostolle F, Gauss T, Hamada SR, Langlois M, Yordanov Y, Feral-Pierssens AL, Woloch A, Ogereau C, Gayat E, Attias A, Pateron D, Castier Y, Ludes B, Dolla E, Tourtier JP, Riou B, Raux M, Ausset S. J. Trauma Acute Care Surg. 2020; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Hemorrhage is the leading cause of death after terrorist attack and the immediacy of labile blood product (LBP) administration has a decisive impact on patients' outcome. The main objective of this study was to evaluate the transfusion patterns of the Paris terrorist attack victims, 2015, November 13.
METHODS: We performed a retrospective analysis including all casualties admitted to hospital, aiming to describe the transfusion patterns from admission to the first week after the attack.
RESULTS: Sixty eight out of 337 admitted patients were transfused. More than three-quarters of blood products were consumed in the initial phase (until 14 November 11:59pm), where 282 packed Red Blood Cell units (pRBC) were transfused along with 201 plasmas and 25 platelet units to 55 patients (16% of casualties). Almost 40% of these LBP (134 pRBC, 73 plasmas, 8 platelet units) were transfused within the first 6 hours after the attack. These early transfusions were massive transfusion (MT) for 20/337 (6%) patients and the average plasma/RBC ratio was 0.8 for MT patients who received 366/508 LBP (72%).The median time from admission to pRBC transfusion was 57 min [25-108] and 208 min [52-430] for MT and non-MT patients, respectively. These same time intervals were 119 min [66 - 202] and 222 min [87 - 381] for plasma and 225 min [131 - 289] and 198 min [167 - 230] for platelets.
CONCLUSIONS: Our data suggest that improving transfusion procedures in mass casualty setting should rely more on shortening the time to bring LBP to the bedside than in increasing the stockpile. LEVEL OF EVIDENCE: Level III, Epidemiological Study.
Language: en |