• Shock · Oct 2015

    HEM-1: FUNCTIONAL CAPACITY OF RECONSTITUTED BLOOD IN 1: 1: 1 VERSUS 3: 1: 1 RATIOS: A THROMBELASTOMETRY STUDY.

    • A Driessen, N Schäfer, U Bauerfeind, M Fröhlich, E Stürmer, B Bouillon, and M Maegele.
    • 1Department of Traumatology, Orthopaedic Surgery and Sports Traumatology, Cologne-Merheim Medical Center (CMMC), Cologne, Germany 2Institute for Research in Operative Medicine, Faculty of Health; Witten/Herdecke University, Germany 3Department of Transfusion Medicine, Cologne-Merheim Medical Centre (CMMC), Witten/Herdecke University, Germany.
    • Shock. 2015 Oct 1;44 Suppl 2:1.

    IntroductionDifferent transfusion ratio concepts of red blood cells (pRBCs), fresh frozen plasma (FFPs) and platelets (PLTs) have been implemented in trauma care, but the optimal ratios are still discussed. In this study the hemostatic potential of two predefined ratios was assessed by using an in vitro thrombelastometric approach. Furthermore, age effects of reconstituted blood were analyzed.MethodsWhole blood (WB) of voluntary donors was separated into packed red blood cells (pRBCs), fresh frozen plasma (FFP) and platelets (PLTs) and reconstituted into the ratios 1:1:1 and 3:1:1 at day 1, 4, 14, and 24. Standard blood count, electrolytes and coagulation proteins were quantified. The functional coagulation in ratio and age specific groups was evaluated using rotational thromboelastometry (ROTEM).ResultsSeveral coagulation factors reduced significantly in the 3:1:1 ratio and were consistent with increased INR, decelerated clot formation times and A10 (amplitude 10 minutes after clotting time (CT)), flattened alpha-angle during the EXTEM and diminished MCF for distinct time points during the INTEM, FIBTEM and APTEM assays. With rising age of pRBCs the pH, sodium and potassium reached non-physiological levels.ConclusionUnder standardized in vitro conditions the higher amount of pRBCs in the 3:1:1 ratio diluted coagulation factors significantly on the expense of its functional coagulation capacity. Thus, the coagulation functionality of the 1:1:1 ratio predominated. It might be considered as the standard transfusion strategy particularly in trauma care.

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