Study on blood index and coagulation status of patients with massive blood transfusion due to acute trauma

  Objective  To study the changes of blood index and coagulation status in patients with massive blood transfusion due to acute trauma.

  Methods  A total of 98 patients(all requiring more than 8 U red cells) with acute trauma treated in our hospital were enrolled in this study. The patients with a ratio of 1 to 1 at 24 h of admission(suspended erythrocyte to plasma) were included in the group A, and those with a ratio of 1.5 to 1 were as group B, and the those with a ratio of 2 to 1 were in the group C. Blood coagulation function and blood index were measured before and after blood transfusion in all patients, and the changes of above indicators of the two groups were observed and compared.

  Results  Compared with transfusion before, the activated partial thromboplastin time(APTT) and prothrombin time (PT) of three groups after massive transfusion were prolonged, the FIB level was decreased, and the differences were statistically significant (P < 0.05); the APTT, PT and fibrinogen (FIB) levels of group A and group B showed no significant differences (P>0.05), but the APTT and PT levels of group C were higher and the FIB level was lower than group A and group B (P < 0.05). Compared with before transfusion, blood platelet count (PLT) of the three groups was reduced, hemoglobin (Hb) and hematocrit (HCT) were significantly increased (P < 0.05). There were no significant differences in PLT, Hb, HCT levels between group A and group B(P>0.05). PLT level in group C was significant lower than group A (P < 0.05).

  Conclusion  Massive transfusion of suspended red blood cells can cause disorder of coagulation function, so it is suggested to maintain ratio of 1 to 1 or 1.5 to 1(suspended erythrocyte to plasma), and strengthen the detection of coagulation function and timely supplement missed platelets in the treatment of patients with massive trauma to improve the success rate of treatment.