Clinical, tactical and strategic benefits of a UK Spray Dried Plasma production capability.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Matt Ellington, E Barnard, L Bower, S Huish, L Green, P Moor, T Woolley, R Cardigan
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引用次数: 0

Abstract

UK experience from recent conflicts in Iraq and Afghanistan has resulted in improvements in clinical care of injured patients. Resuscitation and blood transfusion is an area that has seen some of the greatest changes. The ongoing war in Ukraine has highlighted the challenges of medical support to Large-Scale Combat Operations (LSCO), one of which is the ability to deliver blood-based resuscitation near to the point of wounding.Plasma is a key aspect of damage control resuscitation and balanced blood transfusion strategies. It is supported by a strong evidence base, which also demonstrates that early administration improves patient outcomes. Conventional plasma transfusion using thawed fresh frozen plasma (FFP) has logistical constraints that preclude its expedient use in the prehospital environment.Temperature-controlled storage, and transport, of sufficient FFP to support LSCO is unrealistic, and temporary campaigns to increase civilian plasma donations signal a combat intent and could compromise Operational Security.Dried plasma components are stable in storage at ambient temperature. They are easily and quickly reconstituted to produce a plasma component with clinically acceptable clotting and coagulation profiles. The UK has access to dried plasma from two European allies, but availability is very limited and use is off-licence. The ongoing UK dried plasma project will provide clinical, tactical and strategic benefits to UK and allied armed forces in future conflicts.

英国从最近在伊拉克和阿富汗的冲突中汲取的经验改善了对受伤病人的临床护理。复苏和输血是变化最大的一个领域。正在乌克兰进行的战争凸显了为大规模作战行动(LSCO)提供医疗支持所面临的挑战,其中之一就是在受伤点附近进行血液复苏的能力。血浆是损伤控制复苏和平衡输血策略的关键环节,它有强大的证据基础支持,同时也证明早期输血可改善患者的预后。使用解冻的新鲜冰冻血浆(FFP)进行传统的血浆输注受到后勤方面的限制,无法在院前环境中快速使用。温控储存和运输足够的 FFP 以支持 LSCO 是不现实的,而临时增加民用血浆捐赠的活动则表明了作战意图,可能会危及行动安全。干血浆成分在环境温度下储存稳定,易于快速重组,生产出的血浆成分具有临床上可接受的凝血和凝血特征。英国可以从两个欧洲盟国获得干血浆,但供应量非常有限,而且只能在许可证之外使用。英国正在进行的干血浆项目将为英国和盟国武装部队在未来冲突中提供临床、战术和战略方面的益处。
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来源期刊
Bmj Military Health
Bmj Military Health MEDICINE, GENERAL & INTERNAL-
CiteScore
3.10
自引率
20.00%
发文量
116
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