Mordechai Caplan, Natalia Torres-Acevedo, Patrizio Petrone, Lindsay Beach, Reddy H Srinivas, Anna Liveris, Corrado P Marini, John McNelis
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引用次数: 0
Abstract
Introduction: Correction of a prolonged CK-TEG R-time requires the administration of fresh frozen plasma (FFP). However, the relationship between the volume required to normalize the R-time and the patient's plasma volume (PVi) has not been investigated. This study investigated the impact of the PVi on the amount of FFP needed to normalize the R-time.
Methods: 30 patients receiving FFP to normalize their R-times were analyzed from the standpoint of sex distribution and R-time response to the administration of FFP. PVi was calculated as blood volume minus hematocrit (Hct). Data included age, sex, height, weight, Hct, changes in PVi (ΔPV) and ΔR-time within 24 h of administration of FFP. Responders were divided in high and low based on a decrease in R-time > 5 min after the administration of FFP. Data presented as mean ± SD and median with interquartile range were analyzed with parametric and non-parametric tests as applicable.
Results: Females had a smaller PVi (2.6 ± 0.4 vs. 3.7 ± 0.6; p < 0.05), yielding a larger ΔPV (14.0 ± 7.0% vs. 10.6 ± 5.4% from 353 ± 141 vs. 381 ± 174 ml of FFP, respectively; p > 0.05). They required less FFP for a ΔR-time of one minute (80 ± 59 vs. 116 ± 64 ml; p > 0.05). There was a significant difference in the number of high responders between females and males (7/11 vs. 5/19; p < 0.05). The R-time response did not differ with respect to age, and the PVi before transfusions but it was affected by the amount FFP and the resulting ΔPV (483 ± 173 vs. 296 ± 99 and 17.0% ± 6.6% vs. 8.6% ± 3.0%; p < 0.05).
Conclusions: We conclude that: 1) The amount of FFP required to normalize the R-time is lower than the recommended dose of 10-20 ml/kg: 2) 6.8 ml/kg of FFP, corresponding to an initial administration of two units of FFP (~ 500 ml) will provide an increase of 15.6% in the concentration of coagulation factors sufficient to normalize the R-time: 3) The assessment of PVi is the key element required to estimate the volume of FFP needed to correct a prolonged R-time.
纠正延长的CK-TEG r时间需要新鲜冷冻血浆（FFP）的管理。然而，R-time正常化所需的容量与患者血浆容量（PVi）之间的关系尚未研究。本研究探讨了PVi对使R-time正常化所需FFP量的影响。方法：对30例经FFP治疗后r时间正常化的患者进行性别分布和r时间反应分析。PVi计算为血容量减去红细胞压积（Hct）。数据包括给药后24小时内年龄、性别、身高、体重、Hct、PVi变化（ΔPV）和ΔR-time。根据给予FFP后5 min R-time bbb的减少情况将应答者分为高应答者和低应答者。以均数±标准差和中位数表示的数据采用参数检验和非参数检验（如适用）进行分析。结果：女性的PVi较小（2.6±0.4 vs 3.7±0.6）；p 0.05)。他们需要较少的FFP ΔR-time 1分钟（80±59 vs 116±64 ml）；p > 0.05)。高应答者的数量在男性和女性之间有显著差异(7/11 vs 5/19；p i在输血前，但受FFP量和结果ΔPV（483±173 vs 296±99）和（17.0%±6.6% vs 8.6%±3.0%）的影响；p结论:我们认为:1)所需的FFP正常化时间低于10 - 20毫升/公斤的推荐剂量:2)6.8毫升/公斤的FFP,对应于初始管理的两个单位的FFP(~ 500毫升)将提供增长15.6%浓度的凝固因素足以正常化时间:3)元太是关键元素的评估需要估计的体积FFP正确需要长时间。
期刊介绍：
The European Journal of Trauma and Emergency Surgery aims to open an interdisciplinary forum that allows for the scientific exchange between basic and clinical science related to pathophysiology, diagnostics and treatment of traumatized patients. The journal covers all aspects of clinical management, operative treatment and related research of traumatic injuries.
Clinical and experimental papers on issues relevant for the improvement of trauma care are published. Reviews, original articles, short communications and letters allow the appropriate presentation of major and minor topics.
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