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lunes, 5 de noviembre de 2018

Prehospital Plasma in Trauma

REBEL Cast Ep60 - November 5, 2018 - By Ashley Liebig
..."Different Outcomes in COMBAT and PAMPer:
  • Patients slightly older in PAMPer Trial vs COMBAT Trial (40’s vs 30’s)
  • More Crystalloid used in PAMPer Trial vs COMBAT Trial (500 – 900cc vs 150 – 250cc)
  • More Blunt Injury in PAMPer Trial vs COMBAT Trial (>80% vs ≈50%)
  • Transport Times Longer in PAMPer Trial vs COMBAT Trial 39 – 52min vs 16 – 28min
Clinical Take Home Point:
In injured patients at risk for hemorrhagic shock, pre-hospital administration of thawed plasma appears to be a safe and efficacious practice in reducing mortality. The difference in mortality outcomes between the COMBAT and PAMPer trials may simply be the longer transport times and the amount of crystalloids, which begs the question of whether we should be resuscitating these patients with crystalloid fluids at all?..."