From the Department of Anesthesiology and Intensive Care (C.N., J.B., P.-J.C., P.E., M.C., Q.M., J.C., B.P., E.M.) and Emergency Department (S.B.), Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne, France; and Centre de transfusion sanguine des armées (A.S.), Hôpital d'Instruction des Armées Percy, France.
J Trauma Acute Care Surg. 2018 May;84(5):780-785. doi: 10.1097/TA.0000000000001801.
Early transfusion of high ratio of fresh frozen plasma (FFP) and red blood cells (RBC) is associated with mortality reduction. However, time to reach high ratio is limited by the need to thaw the FFP. French lyophilized plasma (FLYP) used by French army and available in military teaching hospital does not need to be thawed and is immediately available. We hypothesize that the use of FLYP may reduce time to reach a plasma/RBC ratio of 1:1.
A retrospective study performed in a Level 1 trauma center between January 2012 and December 2015. Severe trauma patients who received 2 U of RBC in the emergency room were included and assigned to two groups according to first plasma transfused: FLYP group and FFP group.
Forty-three severe trauma patients in the FLYP group and 29 in the FFP group were included. The time until first plasma transfusion was shorter in the FLYP group than in the FFP group, respectively 15 min (10-25) versus 95 min (70-145) (p < 0.0001). Time until a 1:1 ratio was shorter in the FLYP group than in the FFP group. There were significantly fewer cases of massive transfusion in the FLYP group than in the FFP group with respectively 7% vs. 45% (p < 0.0001).
The use of FLYP provided significantly faster plasma transfusions than the use of FFP as well as a plasma and RBC ratio superior to 1:2 that was reached more rapidly in severe trauma patients. These results may explain the less frequent need for massive transfusion in the patients who received FLYP. These positive results should be confirmed by a prospective and randomized evaluation.
Therapeutic, level IV.
早期输注高比例新鲜冰冻血浆（FFP）和红细胞（RBC）与死亡率降低有关。然而，达到高比例的时间受到需要解冻 FFP 的限制。法国军队使用的冻干血浆（FLYP）和在军事教学医院中可用的 FLYP 不需要解冻，并且可以立即使用。我们假设使用 FLYP 可以减少达到血浆/RBC 比例为 1:1 的时间。
这是一项在 2012 年 1 月至 2015 年 12 月期间在一级创伤中心进行的回顾性研究。在急诊室接受 2 单位 RBC 输注的严重创伤患者被纳入研究，并根据首次输注的血浆分为两组：FLYP 组和 FFP 组。
FLYP 组纳入 43 例严重创伤患者，FFP 组纳入 29 例。FLYP 组的首次血浆输注时间明显短于 FFP 组，分别为 15 分钟（10-25）与 95 分钟（70-145）（p<0.0001）。FLYP 组达到 1:1 比例的时间也明显短于 FFP 组。FLYP 组大量输血的病例明显少于 FFP 组，分别为 7%与 45%（p<0.0001）。
与 FFP 相比，FLYP 能更快地提供血浆输注，同时也能更快地达到血浆和 RBC 比例优于 1:2，这在严重创伤患者中更为明显。这些结果可能解释了接受 FLYP 的患者较少需要大量输血的原因。这些积极的结果需要通过前瞻性和随机评估来证实。
治疗性，IV 级。
