BLOOD COMPONENT SUPPLEMENTATION DURING MASSIVE TRANSFUSION OF AS-1 RED-CELLS IN TRAUMA PATIENTS

Coagulation component transfusions in trauma patients given more than 10 units of AS-1 red cells during the first 24 hours after injury were studied. Serial coagulation tests were obtained to direct component t herapy. Coagulopathy developed in more than 70% of patients. Patients with blunt or penetrating trauma had similar coagulation abnormalities during massive transfusions. More than 40% of patients with either ex sanguinating hemorrhage from penetrating trauma or blunt trauma with a ssociated brain injuries had abnormal coagulation tests on admission. In contrast, patients with blunt trauma, but without brain injury, did not have coagulopathy on admission. Patients received an average of 2 5 units (range, 10-77) of AS-1 red cells and were exposed to an averag e of 80 (range, 11-252) donors. Exsanguination and brain injuries prim arily caused death in 57%. Abnormal coagulation tests will be frequent and profound during a massive transfusion with AS-1 red cells. Serial coagulation testing is recommended.