Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2018
Mortality of civilian patients with suspected traumatic haemorrhage receiving pre-hospital transfusion of packed red blood cells compared to pre-hospital crystalloid.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Pre-hospital transfusion of red blood cells. Part 2: A systematic review of treatment effects on outcomes.Transfusion medicine (Oxford, England) · 2020Pooled it
- Effects of external factors on red blood cell concentrate quality during helicopter transport: a pilot study.World journal of emergency medicine · 2026Article
- [Resuscitative endovascular balloon occlusion of the aorta-REBOA for bleeding control in the prehospital context : Overview of available cases and evaluation of the evidence].Die Anaesthesiologie · 2025Review
- Prehospital blood for the injured in conflict zones: what about civilians? - a scoping review.Conflict and health · 2025Review
- Pre-hospital assessment of trauma associated severe hemorrhage (phTASH) - analysis of TraumaRegister DGUScandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- [The golden approach to trauma. Which blood products are needed for optimization of prehospital trauma care?]Die Anaesthesiologie · 2024Article
- Prehospital blood transfusion in Brazil: results of the first year of implementation in an emergency medical service.Hematology, transfusion and cell therapy · 2024Article
- Article
- Pre-Hospital Blood Products for the Care of Bleeding Trauma Patients.Deutsches Arzteblatt international · 2023Review
- Association of red blood cells and plasma transfusion versus red blood cell transfusion only with survival for treatment of major traumatic hemorrhage in prehospital setting in England: a multicenter study.Critical care (London, England) · 2023Article
- Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries.Critical care (London, England) · 2022Review
- Initial experiences of prehospital blood product transfusions between 2016 and 2020 in Päijät-Häme hospital district, Finland.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Noninferior Red Cell Concentrate Quality after Repeated Air Rescue Mission Transport for Prehospital Transfusion.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2022Article
- Low-Titer Group O Whole-Blood Resuscitation in the Prehospital Setting in Israel: Review of the First 2.5 Years' Experience.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2021Review
- Wearable Sensors Incorporating Compensatory Reserve Measurement for Advancing Physiological Monitoring in Critically Injured Trauma Patients.Sensors (Basel, Switzerland) · 2020Review
- Pre-hospital transfusion of red blood cells. Part 1: A scoping review of current practice and transfusion triggers.Transfusion medicine (Oxford, England) · 2020Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMajor haemorrhage is a leading cause of mortality following major trauma. Increasingly, Helicopter Emergency Medical Services (HEMS) in the United Kingdom provide pre-hospital transfusion with blood products, although the evidence to support this is equivocal. This study compares mortality for patients with suspected traumatic haemorrhage transfused with pre-hospital packed red blood cells (PRBC) compared to crystalloid.
methodsA single centre retrospective observational cohort study between 1 January 2010 and 1 February 2015. Patients triggering a pre-hospital Code Red activation were eligible. The primary outcome measure was all-cause mortality at 6 hours (h) and 28 days (d), including a sub-analysis of patients receiving a major and massive transfusion. Multivariable regression models predicted mortality. Multiple Imputation was employed, and logistic regression models were constructed for all imputed datasets.
resultsThe crystalloid (n = 103) and PRBC (n = 92) group were comparable for demographics, Injury Severity Score (p = 0.67) and mechanism of injury (p = 0.73). Observed 6 h mortality was smaller in the PRBC group (n = 10, 10%) compared to crystalloid group (n = 19, 18%). Adjusted OR was not statistically significant (OR 0.48, CI 0.19-1.19, p = 0.11). Observed mortality at 28 days was smaller in the PRBC group (n = 21, 26%) compared to crystalloid group (n = 31, 40%), p = 0.09. Adjusted OR was not statistically significant (OR 0.66, CI 0.32-1.35, p = 0.26). A statistically significant greater proportion of the crystalloid group required a major transfusion (n = 62, 60%) compared to the PRBC group (n = 41, 40%), p = 0.02. For patients requiring a massive transfusion observed mortality was smaller in the PRBC group at 28 days (p = 0.07).
conclusionIn a single centre UK HEMS study, in patients with suspected traumatic haemorrhage who received a PRBC transfusion there was an observed, but non-significant, reduction in mortality at 6 h and 28 days, also reflected in a massive transfusion subgroup. Patients receiving pre-hospital PRBC were significantly less likely to require an in-hospital major transfusion. Further adequately powered multi-centre prospective research is required to establish the optimum strategy for pre-hospital volume replacement in patients with traumatic haemorrhage.
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