{"title":"重伤患者坚持均衡输血：RESTRIC 试验的事后分析","authors":"Makoto Aoki, Kazunori Fukushima, Mineji Hayakawa, Daisuke Kudo, Takashi Tagami, Kiyohiro Oshima, Shigeki Kushimoto","doi":"10.1002/ams2.70016","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>A balanced transfusion strategy has been a standard resuscitation method for trauma patients, and adherence to a massive transfusion protocol incorporating balanced transfusion is reported to reduce mortality. This study aimed to assess adherence to balanced transfusion among severely injured patients in Japan.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study analyzes RESTRIC (restrictive transfusion strategy for critically injured patients) trial patients who were cluster-randomized based on restrictive or liberal transfusion strategy. We defined two transfusion groups: massive transfusion group 1, which includes RBC transfusions of at least eight units within 6 h; and massive transfusion group 2, which includes RBC transfusions of at least 20 units within 24 h. Adherence to balanced transfusion was assessed as the ratios of fresh frozen plasma (FFP) to red blood cells (RBC) and platelet concentrate (PC) to RBC ratio >0.5.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 220 eligible patients, 98 (44.5%) were grouped as massive transfusion group 1 and 38 (17.3%) as massive transfusion group 2. The balanced transfusion in terms of the FFP to RBC ratio was nearly 100% for groups 1 and 2 over all periods. However, the balanced transfusion in terms of the PC to RBC ratio within 6 h were 51.0% for group 1 and 68.4% for group 2.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study revealed that while the ratio of FFP to RBC was balanced among patients from the early phase, the ratio of PC to RBC was not fully balanced, particularly in the early phase.</p>\n </section>\n </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70016","citationCount":"0","resultStr":"{\"title\":\"Adherence to balanced transfusion among severely injured patients: A post hoc analysis of the RESTRIC trial\",\"authors\":\"Makoto Aoki, Kazunori Fukushima, Mineji Hayakawa, Daisuke Kudo, Takashi Tagami, Kiyohiro Oshima, Shigeki Kushimoto\",\"doi\":\"10.1002/ams2.70016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>A balanced transfusion strategy has been a standard resuscitation method for trauma patients, and adherence to a massive transfusion protocol incorporating balanced transfusion is reported to reduce mortality. This study aimed to assess adherence to balanced transfusion among severely injured patients in Japan.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This study analyzes RESTRIC (restrictive transfusion strategy for critically injured patients) trial patients who were cluster-randomized based on restrictive or liberal transfusion strategy. We defined two transfusion groups: massive transfusion group 1, which includes RBC transfusions of at least eight units within 6 h; and massive transfusion group 2, which includes RBC transfusions of at least 20 units within 24 h. Adherence to balanced transfusion was assessed as the ratios of fresh frozen plasma (FFP) to red blood cells (RBC) and platelet concentrate (PC) to RBC ratio >0.5.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among 220 eligible patients, 98 (44.5%) were grouped as massive transfusion group 1 and 38 (17.3%) as massive transfusion group 2. The balanced transfusion in terms of the FFP to RBC ratio was nearly 100% for groups 1 and 2 over all periods. However, the balanced transfusion in terms of the PC to RBC ratio within 6 h were 51.0% for group 1 and 68.4% for group 2.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>This study revealed that while the ratio of FFP to RBC was balanced among patients from the early phase, the ratio of PC to RBC was not fully balanced, particularly in the early phase.</p>\\n </section>\\n </div>\",\"PeriodicalId\":7196,\"journal\":{\"name\":\"Acute Medicine & Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70016\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acute Medicine & Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ams2.70016\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute Medicine & Surgery","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ams2.70016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Adherence to balanced transfusion among severely injured patients: A post hoc analysis of the RESTRIC trial
Aim
A balanced transfusion strategy has been a standard resuscitation method for trauma patients, and adherence to a massive transfusion protocol incorporating balanced transfusion is reported to reduce mortality. This study aimed to assess adherence to balanced transfusion among severely injured patients in Japan.
Methods
This study analyzes RESTRIC (restrictive transfusion strategy for critically injured patients) trial patients who were cluster-randomized based on restrictive or liberal transfusion strategy. We defined two transfusion groups: massive transfusion group 1, which includes RBC transfusions of at least eight units within 6 h; and massive transfusion group 2, which includes RBC transfusions of at least 20 units within 24 h. Adherence to balanced transfusion was assessed as the ratios of fresh frozen plasma (FFP) to red blood cells (RBC) and platelet concentrate (PC) to RBC ratio >0.5.
Results
Among 220 eligible patients, 98 (44.5%) were grouped as massive transfusion group 1 and 38 (17.3%) as massive transfusion group 2. The balanced transfusion in terms of the FFP to RBC ratio was nearly 100% for groups 1 and 2 over all periods. However, the balanced transfusion in terms of the PC to RBC ratio within 6 h were 51.0% for group 1 and 68.4% for group 2.
Conclusion
This study revealed that while the ratio of FFP to RBC was balanced among patients from the early phase, the ratio of PC to RBC was not fully balanced, particularly in the early phase.
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