Thibault Martinez1, Anne François, Thomas Pouget, Pierre Carli, Frédéric Lapostolle, Tobias Gauss, Sophie Rym Hamada, Matthieu Langlois, Youri Yordanov, Anne-Laure Féral-Pierssens, Alexandre Woloch, Carl Ogereau, Etienne Gayat, Arié Attias, Dominique Pateron, Yves Castier, Bertrand Ludes, Emmanuelle Dolla, Jean-Pierre Tourtier, Bruno Riou, Mathieu Raux, Sylvain Ausset. 1. From the Department of Anaesthesiology and Critical Care (T.M., S.A.), Percy Military Hospital, Clamart; French Blood Institute (A.F.), Paris, France; French Military Blood Institute (T.P.), Clamart, France; SAMU 75 (P.C.), Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; SAMU 93 (F.L.), Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France; Department of Anaesthesiology and Critical Care (T.G.), Hôpital Beaujon, Hôpitaux Universitaires Paris Nord-Val-De-Seine, Assistance Publique-Hôpitaux de Paris, Clichy, France; Université Paris Sud, Department of Anesthesiology and Critical Care (S.R.H.), Assistance Publique-Hôpitaux de Paris, Bicêtre Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France; CESP, INSERM, Université Paris-Sud (S.R.H.), UVSQ, Université Paris-Saclay, France; CESP, INSERM, Maison de Solenn (S.R.H.), France; Service Médical du RAID (M.L.), Bièvres, France; Groupe Hospitalier Pitié-Salpêtrière-Charles Foix, Department of Anaesthesiology and Critical Care (M.L., E.D., M.R.), Groupe Hospitalier Pitié-Salpêtrière-Charles Foix, Department of Emergency Medicine and Surgery (B.R.), Hôpital Saint-Antoine, Department of Emergency (Y.Y., D.P.), France, Hôpital Européen Georges Pompidou, Emergency Department (A.-L.F.-P.), Assistance Publique-Hôpitaux de Paris, Paris, France; Begin Military Hospital, Department of Emergency (A.W.), Saint Mandé, France; Hôpital Saint Louis, Department of Emergency (C.O.), Hôpital Lariboisière, Department of Anesthesiology and Critical Care (E.G.), Assistance Publique-Hôpitaux de Paris, Paris, France; Hôpital Henri Mondor, Department of Anaesthesiology and Critical Care (A.A.), Assistance Publique-Hôpitaux de Paris, Créteil, France; Hôpital Bichat, Division of Vascular Surgery (Y.C.), Assistance Publique-Hôpitaux de Paris, Paris, France; Institut Médico-légal de Paris (B.L.), Paris, France; Paris Fire Brigade, Emergency Medical Department (J.-P.T.), Paris, France; French Military Health Service Schools (S.A.), Lyon, France; Université Paris Diderot (E.G., Y.C.), Paris, France; Université Paris Descartes (P.C., B.L.), Paris, France; Université Paris 13 (F.L.), Bobigny, France; Sorbonne Université (M.R.), UMRS Inserm 1158, France; Sorbonne Université (D.P., B.R.), UMRS Inserm 1166, IHU ICAN, Paris, France; and Sorbonne Université (Y.Y.), UMRS Inserm 1136, Paris, France.
Abstract
OBJECTIVE: Hemorrhage is the leading cause of death after terrorist attack, and the immediacy of labile blood product (LBP) administration has a decisive impact on patients' outcome. The main objective of this study was to evaluate the transfusion patterns of the Paris terrorist attack victims, November 13, 2015. METHODS: We performed a retrospective analysis including all casualties admitted to hospital, aiming to describe the transfusion patterns from admission to the first week after the attack. RESULTS: Sixty-eight of 337 admitted patients were transfused. More than three quarters of blood products were consumed in the initial phase (until November 14, 11:59 PM), where 282 packed red blood cell (pRBC) units were transfused along with 201 plasma and 25 platelet units, to 55 patients (16% of casualties). Almost 40% of these LBPs (134 pRBC, 73 plasma, 8 platelet units) were transfused within the first 6 hours after the attack. These early transfusions were massive transfusion (MT) for 20 (6%) of 337 patients, and the average plasma/red blood cell ratio was 0.8 for MT patients who received 366 (72%) of 508 LBPs.The median time from admission to pRBC transfusion was 57 (25-108) minutes and 208 (52-430) minutes for MT and non-MT patients, respectively. These same time intervals were 119 (66-202) minutes and 222 (87-381) minutes for plasma and 225 (131-289) minutes and 198 (167-230) minutes for platelets. CONCLUSION: Our data suggest that improving transfusion procedures in mass casualty setting should rely more on shortening the time to bring LBP to the bedside than in increasing the stockpile. LEVEL OF EVIDENCE: Epidemiological study, Therapeutic IV.
OBJECTIVE:Hemorrhage is the leading cause of death after terrorist attack, and the immediacy of labile blood product (LBP) administration has a decisive impact on patients' outcome. The main objective of this study was to evaluate the transfusion patterns of the Paris terrorist attack victims, November 13, 2015. METHODS: We performed a retrospective analysis including all casualties admitted to hospital, aiming to describe the transfusion patterns from admission to the first week after the attack. RESULTS: Sixty-eight of 337 admitted patients were transfused. More than three quarters of blood products were consumed in the initial phase (until November 14, 11:59 PM), where 282 packed red blood cell (pRBC) units were transfused along with 201 plasma and 25 platelet units, to 55 patients (16% of casualties). Almost 40% of these LBPs (134 pRBC, 73 plasma, 8 platelet units) were transfused within the first 6 hours after the attack. These early transfusions were massive transfusion (MT) for 20 (6%) of 337 patients, and the average plasma/red blood cell ratio was 0.8 for MT patients who received 366 (72%) of 508 LBPs.The median time from admission to pRBC transfusion was 57 (25-108) minutes and 208 (52-430) minutes for MT and non-MT patients, respectively. These same time intervals were 119 (66-202) minutes and 222 (87-381) minutes for plasma and 225 (131-289) minutes and 198 (167-230) minutes for platelets. CONCLUSION: Our data suggest that improving transfusion procedures in mass casualty setting should rely more on shortening the time to bring LBP to the bedside than in increasing the stockpile. LEVEL OF EVIDENCE: Epidemiological study, Therapeutic IV.