Guosheng Wu1, Mingzhu Zhuang2, Xiaoming Fan3, Xudong Hong4, Kangan Wang5, He Wang6, Zhengli Chen7, Yu Sun8, Zhaofan Xia9. 1. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: drwuguosheng@sina.cn. 2. Department of Blood Transfusion, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: zmz_smmu@sina.com. 3. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: fxm_smmu@sina.com. 4. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: hxd_smmu@sina.com. 5. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: wkasmmu@163.com. 6. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: wh_smmu@sina.com. 7. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: czl_smmu@sina.com. 8. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: sy_smmu@sina.com. 9. Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: xiazhaofan_smmu@163.com.
Abstract
BACKGROUND: Blood is a vital resource commonly used in burn patients; however, description of blood transfusions in severe burns is limited. The purpose of this study was to describe the epidemiology of blood transfusions and determine factors associated with increased transfusion quantity. METHODS: This is a retrospective study of total 133 patients with >40% total body surface area (TBSA) burns admitted to the burn center of Changhai hospital from January 2008 to December 2013. The study characterized blood transfusions in severe burn patients. Univariate and Multivariate regression analyses were used to evaluate the association of clinical variables with blood transfusions. RESULTS: The overall transfusion rate was 97.7% (130 of 133). The median amount of total blood (RBC and plasma), RBC and plasma transfusions was 54 units (Interquartile range (IQR), 20-84), 19 units (IQR, 4-37.8) and 28.5 units (IQR, 14.8-51.8), respectively. The number of RBC transfusion in and outside operation room was 7 (0, 14) and 11 (2, 20) units, and the number of plasma was 6 (0.5, 12) and 21 (11.5, 39.3) units. A median of one unit of blood was transfused per TBSA and an average of 4 units per operation was given in the series. The consumption of plasma is higher than that of RBC. On multivariate regression analysis, age, full-thickness TBSA and number of operations were significant independent predictors associated with the number of RBC transfusion, and coagulopathy and ICU length showed a trend toward RBC consumption. Predictors for increased plasma transfusion were female, high full-thickness TBSA burn and more operations. CONCLUSIONS: Severe burn patients received an ample volume of blood transfusions. Fully understanding of predictors of blood transfusions will allow physicians to better optimize burn patients during hospitalization in an effort to use blood appropriately.
BACKGROUND: Blood is a vital resource commonly used in burn patients; however, description of blood transfusions in severe burns is limited. The purpose of this study was to describe the epidemiology of blood transfusions and determine factors associated with increased transfusion quantity. METHODS: This is a retrospective study of total 133 patients with >40% total body surface area (TBSA) burns admitted to the burn center of Changhai hospital from January 2008 to December 2013. The study characterized blood transfusions in severe burn patients. Univariate and Multivariate regression analyses were used to evaluate the association of clinical variables with blood transfusions. RESULTS: The overall transfusion rate was 97.7% (130 of 133). The median amount of total blood (RBC and plasma), RBC and plasma transfusions was 54 units (Interquartile range (IQR), 20-84), 19 units (IQR, 4-37.8) and 28.5 units (IQR, 14.8-51.8), respectively. The number of RBC transfusion in and outside operation room was 7 (0, 14) and 11 (2, 20) units, and the number of plasma was 6 (0.5, 12) and 21 (11.5, 39.3) units. A median of one unit of blood was transfused per TBSA and an average of 4 units per operation was given in the series. The consumption of plasma is higher than that of RBC. On multivariate regression analysis, age, full-thickness TBSA and number of operations were significant independent predictors associated with the number of RBC transfusion, and coagulopathy and ICU length showed a trend toward RBC consumption. Predictors for increased plasma transfusion were female, high full-thickness TBSA burn and more operations. CONCLUSIONS: Severe burn patients received an ample volume of blood transfusions. Fully understanding of predictors of blood transfusions will allow physicians to better optimize burn patients during hospitalization in an effort to use blood appropriately.
Authors: Tina L Palmieri; James H Holmes; Brett Arnoldo; Michael Peck; Bruce Potenza; Amalia Cochran; Booker T King; William Dominic; Robert Cartotto; Dhaval Bhavsar; Nathan Kemalyan; Edward Tredget; Francois Stapelberg; David Mozingo; Bruce Friedman; David G Greenhalgh; Sandra L Taylor; Brad H Pollock Journal: Ann Surg Date: 2017-10 Impact factor: 12.969
Authors: Tina L Palmieri; James H Holmes; Brett Arnoldo; Michael Peck; Amalia Cochran; Booker T King; William Dominic; Robert Cartotto; Dhaval Bhavsar; Edward Tredget; Francois Stapelberg; David Mozingo; Bruce Friedman; Soman Sen; Sandra L Taylor; Brad H Pollock Journal: Mil Med Date: 2019-03-01 Impact factor: 1.437
Authors: Nicholas J Marsden; Martin Van; Samera Dean; Ernest A Azzopardi; Sarah Hemington-Gorse; Phillip A Evans; Iain S Whitaker Journal: Scars Burn Heal Date: 2017-09-05