Authors
Maslyakov V.V., Sidelnikov S.A., Savchenko A.V., Kustodov S.V., Zhuravleva I.M., Pominova S.M., Ivasko A.O.
Saratov State Medical University named after V.I. Razumovsky, Saratov
Abstract
Hemorrhagic shock is the most severe complication of military trauma. It requires special attention among the main causes of death. Blood loss and associated hemorrhagic complications can be prevented, so the provision of effective medical care at the prehospital stage is an actual question. The review presents data from PubMed and open information from other Internet resources covering the issues of prehospital care for traumatic hemorrhagic shock. We conducted a comparative analysis of the use of various infusion-transfusion media and studied their features and results of use. We also explored the main advantages and disadvantages of using infusions with crystalloid and colloid solutions and considered the possibility and necessity of transfusions at the prehospital stage. In addition, we studied their effect on patient survival. It was found that if transfusion therapy is carried out on time, the mortality rate will be reduced. However, there are some logistical limitations, so further researches are needed to optimize their use in the prehospital stage. Also, the using of artificial blood products (for example, perftoran) as unique blood substitutes with a gas transport function is one of the promising areas.
Keywords: hemorrhagic shock; prehospital emergency care; infusion therapy.
References
1. Russo R, Kemp M, Bhatti UF, et al. Life on the battlefield: Valproic acid for combat applications. Journal of Trauma and Acute Care Surgery. 2020; 89(2S): 69-76. doi:10.1097/ta.0000000000002721.
2. Maslyakov VV, Chuprina AP, Kurkin KG. Improving the provision of surgical care to civilians with gunshot wounds of the chest in conditions of local armed conflict. Emergency medical care. 2021; 22(1): 70-75. (In Russ.) doi: 10.24884/2072-6716-2021-22-1-70-75.
3. McIntyre J. Syrian Civil War: a systematic review of trauma casualty epidemiology. BMJ Mil Health. 2020; 166(4): 261-265. doi: 10.1136/ jramc-2019-001304.
4. Kotwal RS, Staudt AM, Mazuchowski EL, et al. A US military Role 2 forward surgical team database study of combat mortality in Afghanistan. J Trauma Acute Care Surg. 2018; 85(3): 603-612. doi:10.1097/ta.0000000000001997.
5. Thies KC, Truhlář A, Keene D, et al. Pre-hospital blood transfusion — an ESA survey of European practice. Scand J Trauma Resusc Emerg Med. 2020; 28: 79. doi:10.1186/s13049-020-00774-1.
6. Donati A, Domizi R, Damiani E, et al. From macrohemodynamic to the microcirculation. Crit. Care Res. Pract. 2013; 2013: 892710. doi:10.1155/ 2013/892710.
7. Moroz VV, Myagkova EA, Zhanataev AK, et al. DNA damage and leukocyte cell death in patients with severe trauma. General resuscitation. 2014; 10(4): 11-36. (In Russ.)
8. Ivanov VA, Makhova KV. Extreme conditions. Shock. Kursk; 2016. (In Russ.)
9. Joint Trauma System Clinical Practice Guideline (JTSCPG). Damage Control Resuscitation (CPG ID: 18). 2017. Accessed May 24, 2021.
10. Chursin VV. Transfusion therapy in acute massive blood loss. Guidelines. Almaty, 2012. 47p. (In Russ.)
11. Mazurok VA. Obvious and controversial issues of replenishment of acute massive blood loss (lecture). Surgical practice. 2013; 4: 11-19. (In Russ.)
12. Cap AP, Pidcoke HF, DePasquale M, et al. Blood far forward: Time to get moving! J Trauma Acute Care Surg. 2015; 78(6 Suppl 1): S2-6.
13. Wu MC, Liao TY, Lee EM, et al. Administration of Hypertonic Solutions for Hemorrhagic Shock: A Systematic Review and Meta-analysis of Clinical Trials. Anesth Analg. 2017 Nov; 125(5): 1549-1557. doi:10.1213/ane. 0000000000002451.
14. Usenko LV, Tsar’ov OV. Blood substitutes with a gas transport function: hopes and realities. MNS. 2018; 1: 88. (In Russ.)
15. Huang GS, Dunham CM. Mortality outcomes in trauma patients undergoing prehospital red blood cell transfusion: a systematic literature review. Int J Burns Trauma. 2017; 7(2): 17-26.
16. Holcomb JB, Donathan DP, Cotton BA, et all. Prehospital Transfusion of Plasma and Red Blood Cells in Trauma Patients. Prehosp Emerg Care. 2015; 19(1): 1-9. doi:10.3109/10903127.2014.923077.
17. Shackelford SA, del Junco DJ, Powell-Dunford N, et al. Association of Prehospital Blood Product Transfusion During Medical Evacuation of Combat Casualties in Afghanistan With Acute and 30-Day Survival. JAMA. 2017; 318(16): 1581-1591. doi:10.1001/jama.2017.15097.
18. Sperry JL, Guyette FX, Brown JB, et al. PAMPer Study Group. Prehospital plasma during air medical transport in trauma patients at risk for hemorrhagic shock. N Engl J Med. 2018; 379(4): 315-326.
19. Moore HB, Moore EE, Chapman MP, et al. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018; 392(10144): 283-291. doi:10.1016/s0140-6736(18)31553-8.
20. Pusateri AE, Moore EE, Moore HB, et al. Association of Prehospital Plasma Transfusion With Survival in Trauma Patients With Hemorrhagic Shock When Transport Times Are Longer Than 20 Minutes: A Post Hoc Analysis of the PAMPer and COMBAT Clinical Trials. JAMA Surg. 2020; 155(2): e195085. doi:10.1001/jamasurg.2019.5085.
21. Guyette FX, Sperry JL, Peitzman AB, et al. Prehospital Blood Product and Crystalloid Resuscitation in the Severely Injured Patient: A Secondary Analysis of the Prehospital Air Medical Plasma Trial. Ann Surg. 2021; 273(2): 358-364. doi:10.1097/sla.0000000000003324.
22. Holcomb JB, Fox EE, Wade CE. PROMMTT Study Group. The Prospective Observational Multicenter Major Trauma Transfusion PROMMTT study. The Journal of Trauma and Acute Care Surgery. 2013; 75(1): 1-2. doi:10.1097/ta.0b013e3182983876.
23. Baraniuk S, Tilley BC, del Junco DJ, et al. PROPPR Study Group. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. Injury. 2014. doi:10.1016/j.injury.2014.06. 001.
24. Fisher AD, Miles EA, Cap AP, et al. Tactical damage control resuscitation. Military Medicine. 2015; 180(8): 869-875. doi:10.7205/milmed-d-14-00721.
25. Strandenes G, De Pasquale, Cap AP, et al. Emergency Whole-Blood Use in the Field: A Simplified Protocol for Collection and Transfusion. Shock. 2014; 41(1): 76-83. doi:10.1097/shk.0000000000000114.
