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European Journal of Trauma and Emergency Surgery

Erschienen in:

07.04.2018 | Original Article

Platelet transfusion increases risk for acute respiratory distress syndrome in non-massively transfused blunt trauma patients

verfasst von: George Kasotakis, Nichole Starr, Erek Nelson, Bedabrata Sarkar, Peter Ashley Burke, Daniel George Remick, Ronald Gary Tompkins, The Inflammation and Host Response to Injury Investigators

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2019

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Abstract

Purpose

While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients.

Methods

The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified. Patients were divided into quartiles depending on platelet volume they were transfused in the first 48 h. Outcomes of interest included mortality; ventilator, Intensive Care Unit (ICU) and hospital length of stay (LOS); infectious and non-infectious complications. Multivariable regression models were fitted for these outcomes, controlling for age, pre-existing comorbidities, injury severity, acute physiologic derangement, neurologic injury burden, and other fluid and blood product resuscitation.

Results

There was no difference in mortality, LOS, or the incidence of multi-organ failure and infectious complications. However, patients receiving ≥ 250 mL of platelets were more likely to develop acute respiratory distress syndrome (ARDS) compared to those who received < 250 mL [odds ratio 1.91 (95% CI 1.10–3.33, p = 0.022)].

Conclusions

Pre-emptive platelet transfusion should be avoided in non-massively transfused blunt injury victims in the absence of true or functional thrombocytopenia, as it increases risk for ARDS with no survival benefit.

The Injury Center at the Centers for Disease Control and Prevention. Injury prevention & control—data & statistics (WISQARS). 2015. https://www.cdc.gov/injury/wisqars/leadingcauses.html. Accessed 23 Feb 2017.

The World Health Organization. The top 10 causes of death. 2014. https://www.who.int/mediacentre/factsheets/fs310/en/. Accessed 23 Feb 2017.

Cohen MJ. Acute traumatic coagulopathy: clinical characterization and mechanistic investigation. Thromb Res. 2014;133(Suppl 1):S25-7.PubMed

Borgman MA, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, et al. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma. 2007;63:805–13.CrossRefPubMed

Spinella PC, Perkins JG, Grathwohl KW, Beekley AC, Niles SE, McLaughlin DF, et al. Effect of plasma and red blood cell transfusions on survival in patients with combat related traumatic injuries. J Trauma. 2008;64:S69–77 (discussion S-8).CrossRefPubMed

Rowell SE, Barbosa RR, Diggs BS, Schreiber MA, Trauma Outcomes G, Holcomb JB, et al. Effect of high product ratio massive transfusion on mortality in blunt and penetrating trauma patients. J Trauma. 2011;71:S353–7.CrossRefPubMed

MacLennan S, Williamson LM. Risks of fresh frozen plasma and platelets. J Trauma. 2006;60:S46–50.PubMed

Pommerening MJ, Goodman MD, Holcomb JB, Wade CE, Fox EE, Del Junco DJ, et al. Clinical gestalt and the prediction of massive transfusion after trauma. Injury. 2015;46:807–13.CrossRefPubMedPubMedCentral

Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Meyer W, Scalea TM. Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study. World J Surg. 2008;32:2185–9.CrossRefPubMed

10.

Holcomb JB, Wade CE, Michalek JE, Chisholm GB, Zarzabal LA, Schreiber MA, et al. Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008;248:447–58.PubMed

11.

Sambasivan CN, Kunio NR, Nair PV, Zink KA, Michalek JE, Holcomb JB, et al. High ratios of plasma and platelets to packed red blood cells do not affect mortality in nonmassively transfused patients. J Trauma. 2011;71:S329–36.CrossRefPubMed

12.

Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Shih D, Meyer W, et al. Blood product transfusion and ventilator-associated pneumonia in trauma patients. Surg Infect. 2008;9:415–22.CrossRef

13.

Park PK, Cannon JW, Ye W, Blackbourne LH, Holcomb JB, Beninati W, et al. Transfusion strategies and development of acute respiratory distress syndrome in combat casualty care. J Trauma Acute Care Surg. 2013;75:S238–46.CrossRefPubMed

14.

Watson GA, Sperry JL, Rosengart MR, Minei JP, Harbrecht BG, Moore EE, et al. Fresh frozen plasma is independently associated with a higher risk of multiple organ failure and acute respiratory distress syndrome. J Trauma. 2009;67:221–7 (discussion 8–30).CrossRefPubMed

15.

Edens JW, Chung KK, Pamplin JC, Allan PF, Jones JA, King BT, et al. Predictors of early acute lung injury at a combat support hospital: a prospective observational study. J Trauma. 2010;69(Suppl 1):S81–6.CrossRefPubMed

16.

Johnson JL, Moore EE, Kashuk JL, Banerjee A, Cothren CC, Biffl WL, et al. Effect of blood products transfusion on the development of postinjury multiple organ failure. Arch Surg. 2010;145:973–7.CrossRefPubMed

17.

Neal MD, Hoffman MK, Cuschieri J, Minei JP, Maier RV, Harbrecht BG, et al. Crystalloid to packed red blood cell transfusion ratio in the massively transfused patient: when a little goes a long way. J Trauma Acute Care Surg. 2012;72:892–8.CrossRefPubMedPubMedCentral

18.

Kasotakis G, Sideris A, Yang Y, de Moya M, Alam H, King DR, et al. Aggressive early crystalloid resuscitation adversely affects outcomes in adult blunt trauma patients: an analysis of the Glue Grant database. J Trauma Acute Care Surg. 2013;74:1215–21 (discussion 21–2).PubMedPubMedCentral

19.

Evans HL, Cuschieri J, Moore EE, Shapiro MB, Nathens AB, Johnson JL, et al. Inflammation and the host response to injury, a Large-Scale Collaborative Project: patient-oriented research core standard operating procedures for clinical care IX. Definitions for complications of clinical care of critically injured patients. J Trauma. 2009;67:384–8.CrossRefPubMedPubMedCentral

20.

Inaba K, Branco BC, Rhee P, Blackbourne LH, Holcomb JB, Teixeira PG, et al. Impact of plasma transfusion in trauma patients who do not require massive transfusion. J Am Coll Surg. 2010;210:957–65.CrossRefPubMed

21.

Menitove JE, McElligott MC, Aster RH. Febrile transfusion reaction: what blood component should be given next? Vox Sanguinis. 1982;42:318–21.CrossRefPubMed

22.

Fragkou PC, Torrance HD, Pearse RM, Ackland GL, Prowle JR, Owen HC, et al. Perioperative blood transfusion is associated with a gene transcription profile characteristic of immunosuppression: a prospective cohort study. Critical Care. 2014;18:541.CrossRefPubMedPubMedCentral

23.

Kenz HE, Van der Linden P. Transfusion-related acute lung injury. Eur J Anaesthesiol. 2014;31:345–50.CrossRefPubMed

24.

Salim A, Martin M, Constantinou C, Sangthong B, Brown C, Kasotakis G, et al. Acute respiratory distress syndrome in the trauma intensive care unit: Morbid but not mortal. Arch Surg. 2006;141:655–8.CrossRefPubMed

25.

Popovsky MA, Abel MD, Moore SB. Transfusion-related acute lung injury associated with passive transfer of antileukocyte antibodies. Am Rev Respir Dis. 1983;128:185–9.CrossRefPubMed

26.

Lee YL, King MB, Gonzalez RP, Brevard SB, Frotan MA, Gillespie MN, et al. Blood transfusion products contain mitochondrial DNA damage-associated molecular patterns: a potential effector of transfusion-related acute lung injury. J Surg Res. 2014;191:286–9.CrossRefPubMedPubMedCentral

27.

Webert KE, Blajchman MA. Transfusion-related acute lung injury. Curr Opin Hematol. 2005;12:480–7.CrossRefPubMed

28.

Zarbock A, Ley K. The role of platelets in acute lung injury (ALI). Frontiers Biosci. 2009;14:150–8.CrossRef

29.

Zarbock A, Polanowska-Grabowska RK, Ley K. Platelet-neutrophil-interactions: linking hemostasis and inflammation. Blood Rev. 2007;21:99–111.CrossRefPubMed

30.

Zarbock A, Singbartl K, Ley K. Complete reversal of acid-induced acute lung injury by blocking of platelet-neutrophil aggregation. J Clin Investig. 2006;116:3211–9.CrossRefPubMed

31.

Kasotakis G, Galvan M, King E, Sarkar B, Stucchi A, Mizgerd JP, Burke PA, Remick D. Valproic acid mitigates the inflammatory response and prevents acute respiratory distress syndrome in a murine model of Escherichia coli pneumonia at the expense of bacterial clearance. J Trauma Acute Care Surg. 2017;82(4):758–65.CrossRefPubMedPubMedCentral

32.

Looney MR, Nguyen JX, Hu Y, Van Ziffle JA, Lowell CA, Matthay MA. Platelet depletion and aspirin treatment protect mice in a two-event model of transfusion-related acute lung injury. J Clin Investig. 2009;119:3450–61.PubMed

33.

Looney MR, Roubinian N, Gajic O, Gropper MA, Hubmayr RD, Lowell CA, et al. Prospective study on the clinical course and outcomes in transfusion-related acute lung injury*. Crit Care Med. 2014;42:1676–87.CrossRefPubMedPubMedCentral

34.

Botha AJ, Moore FA, Moore EE, Sauaia A, Banerjee A, Peterson VM. Early neutrophil sequestration after injury: a pathogenic mechanism for multiple organ failure. J Trauma. 1995;39:411–7.CrossRefPubMed

35.

Chen W, Janz DR, Bastarache JA, May AK, O’Neal HR Jr, Bernard GR, et al. Prehospital aspirin use is associated with reduced risk of acute respiratory distress syndrome in critically Ill patients: a propensity-adjusted analysis. Crit Care Med. 2015;43(4):801–7.CrossRef

36.

Harr JN, Moore EE, Johnson J, Chin TL, Wohlauer MV, Maier R, et al. Antiplatelet therapy is associated with decreased transfusion-associated risk of lung dysfunction, multiple organ failure, and mortality in trauma patients. Crit Care Med. 2013;41:399–404.CrossRefPubMedPubMedCentral

37.

Zink KA, Sambasivan CN, Holcomb JB, Chisholm G, Schreiber MA. A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study. Am J Surg. 2009;197:565–70 (discussion 70).

38.

Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015;313:471–82.CrossRefPubMedPubMedCentral

39.

Nydam TL, Kashuk JL, Moore EE, Johnson JL, Burlew CC, Biffl WL, et al. Refractory postinjury thrombocytopenia is associated with multiple organ failure and adverse outcomes. J Trauma. 2011;70:401–6 (discussion 6–7).CrossRefPubMed

40.

Ciesla DJ, Moore EE, Johnson JL, Burch JM, Cothren CC, Sauaia A. The role of the lung in postinjury multiple organ failure. Surgery. 2005;138:749–57 (discussion 57–8).

41.

Lord JM, Midwinter MJ, Chen YF, Belli A, Brohi K, Kovacs EJ, et al. The systemic immune response to trauma: an overview of pathophysiology and treatment. Lancet. 2014;384:1455–65.CrossRefPubMedPubMedCentral

42.

Bierling P, Bux J, Curtis B, Flesch B, Fung L, Lucas G, et al. ISBT Working Party on Granulocyte Immunobiology: Recommendations of the ISBT Working Party on Granulocyte Immunobiology for leucocyte antibody screening in the investigation and prevention of antibody-mediated transfusion-related acute lung injury. Vox Sanguinis. 2009;96:266–9.CrossRefPubMed

43.

Chapman CE, Stainsby D, Jones H, Love E, Massey E, Win N, et al. Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma. Transfusion. 2009;49:440–52.CrossRefPubMed

Titel: Platelet transfusion increases risk for acute respiratory distress syndrome in non-massively transfused blunt trauma patients
verfasst von: George Kasotakis
Nichole Starr
Erek Nelson
Bedabrata Sarkar
Peter Ashley Burke
Daniel George Remick
Ronald Gary Tompkins
The Inflammation and Host Response to Injury Investigators
Publikationsdatum: 07.04.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 4/2019
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0953-4

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Platelet transfusion increases risk for acute respiratory distress syndrome in non-massively transfused blunt trauma patients

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

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Results

Conclusions

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